Clinical question comments:What is the evidence based surgical approach for bilateral salpingo–oophorectomy in premenopausal women with low and high risk apparent early stage endometrial c/Evidence summary and recommendations

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General information on how to comment

• If you have identified any gaps or errors in the content please suggest suitable text for inclusion.
• Statements regarding the inclusion/exclusion of issues should be clearly supported by scientific evidence.

Unsure why 45 is used as the cut-off...perhaps just premenopausal?

MQ

Dear Prof Quin,

Thank you for providing comment on the draft guidelines.

The Working Party has recently met to consider all the public comments received and review the guidelines.

The following is their response to your comments above:

Agree - reworded.

Christine Vuletich Manager, Clinical Guidelines Network Cancer Council Australia

The quoted risk for ovarian cancer in Lynch syndrome is high. This risk was assessed by Australian key opinion leaders in Familial cancer under the auspices of the NSW Cancer Institute cancer treatments on-line, familial cancer committee (www.EviQ.org) and a consensus agreement on an ovarian cancer risk of <10% was reached based on published literature. In addition, as there is evidence that endometrial cancer is the sentinel cancer in 50-60% of women with LS. I would suggest that the recommendation includes the taking of a three generation cancer history pedigree from any premenstrual women undergoing hysterectomy for EC, with particular regard to a family history of EC and CRC. The information gained for this easy and inexpensive clinical assessment would provide clinically relevant information in regard to the likelihood of LS in this patient and would help focus targeted further assessment through mismatch repair immunohistochemistry or referral to a familial cancer clinic for further pre-surgical genetic assessment.