Patient Reported Outcomes after Risk-Reducing Surgery in Patients at Increased Risk of Ovarian Cancer.

Objective. To describe the quality of life of women at an increased risk of ovarian cancer undergoing riskreducing bilateral salpingo-oophorectomy (RRBSO). Methods. Patients evaluated in our gynecologic oncology ambulatory practice between January 2018- December 2019 for an increased risk of ovarian cancer were included. Patients received the EORTC QLQ-C30 and PROMIS emotional and instrumental support questionnaires along with a disease-specific measure (PROM). First and last and pre- and post-surgical PROM responses in each group were compared as were PROMs between at-risk patients and patients with other ovarian diseases. Results. 195 patients with an increased risk of ovarian cancer were identified, 155 completed PROMs (79.5%). BRCA1 or BRCA2 mutations were noted in 52.8%. Also included were 469 patients with benign ovarian disease and 455 with ovarian neoplasms. Seventy-two at-risk patients (46.5%) had surgery and 36 had both pre- and postoperative PROMs. Post-operatively, these patients reported significantly less tension (p = 0.011) and healthrelated worry (p = 0.021) but also decreased levels of health (p = 0.018) and quality of life <7d (0.001), less interest in sex (p = 0.014) and feeling less physically attractive (p = 0.046). No differences in body image or physical/sexual health were noted in at-risk patients who did not have surgery. When compared to patients with ovarian neoplasms, at-risk patients reported lower levels of disease-related life interference and treatment burden, less worry, and better overall health. Conclusions. In patients with an increased risk of ovarian cancer, RRBSO is associated with decreased healthrelated worry and tension, increased sexual dysfunction and poorer short-term quality of life. Patients with ovarian neoplasms suffer to a greater extent than at-risk patients and report higher levels of treatment burden and disease-related anxiety. (c) 2021 Elsevier Inc. All rights reserved.