The challenge of managing isolated STIC lesions: A single-center experience

Objectives: High-grade serous carcinoma (HGSC) arise from serous tubal intraepithelial carcinoma (STIC) lesions, a precursor that develops from the fallopian tube epithelium. Patients with incidental isolated STIC lesions found on salpingectomy specimen have up to 25% risk of developing HGSC or peri...

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Main Authors: Renata Sabelli, Basile Tessier-Cloutier, Lili Fu, Shuk On Annie Leung, Xing Zeng, Reitan Ribeiro, Victoria Mandilaras, Lucy Gilbert, Laurence Bernard
Format: Article
Language:English
Published: Elsevier 2025-04-01
Series:Gynecologic Oncology Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2352578925000414
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Summary:Objectives: High-grade serous carcinoma (HGSC) arise from serous tubal intraepithelial carcinoma (STIC) lesions, a precursor that develops from the fallopian tube epithelium. Patients with incidental isolated STIC lesions found on salpingectomy specimen have up to 25% risk of developing HGSC or peritoneal carcinomatosis in the future, yet there is no established consensus to guide management. Methods: This retrospective case series includes patients diagnosed with isolated STIC lesions between April 2017 and January 2024. Patient data was extracted from clinical and pathological databases. Results: During the study period, 10 patients were diagnosed with an isolated STIC lesion. The fallopian tubes were removed either as part of a hysterectomy for endometrial cancer (n = 3); a prophylactic risk-reducing surgery for BRCA1 or BRCA2 mutation (n = 3); or a benign gynecologic condition (n = 4). The median age of the patients was 64 years (range: 53–80). Among patients who underwent genetic testing (n = 9), only three were found to have a deleterious germline mutation in BRCA1 or BRCA2. The patients either received adjuvant chemotherapy (n = 5) or underwent active surveillance (n = 5). One surveillance patient was managed with completion bilateral oophorectomy and omentectomy. Median number of chemotherapy cycles was four (range 4–6 cycles). The median follow-up was 27 months (range: 5–83 months). One patient under active surveillance was diagnosed with peritoneal carcinomatosis 5 years after initial diagnosis of STIC whereas none recurred in the chemotherapy group. Conclusion: The wide variety of treatment approaches we observed highlights a need for more data on this entity to support management guidelines.
ISSN:2352-5789