Management of incidental STIC lesions with and without BRCA mutations: a survey of current clinical practice in Austria, Germany, and Switzerland

Abstract Objective The aim of this study was to assess current clinical practices, management, and follow-up care for women with an isolated serous tubal intraepithelial carcinoma (STIC) diagnosis in German-speaking countries. Methods An online survey targeting all German-speaking gynecological centers was developed. The survey included single- and multiple-choice questions on hospital data, such as the number of cases per year and certification, as well as detailed questions on two scenarios: a BRCA1 -positive patient undergoing prophylactic bilateral salpingo-oophorectomy and a patient with an incidental STIC finding after hysterectomy and bilateral salpingectomy. Results This survey was answered by 77 physicians. For a patient with a known BRCA1 mutation and STIC, 89.29% of respondents would perform further diagnostics. The most frequent diagnostic steps would be a CA-125 test (83.64%) and a CT abdomen (63.64%). Further surgery would be performed by 77.78% of respondents, including 75.93% without and 5.56% with lymph node staging. 79.25% would prefer laparoscopic surgery. The majority (90.57%) would not recommend adjuvant therapy. In a patient without a known mutation and STIC, 88.46% of respondents would recommend further examinations. 58.82% would carry out genetic panel testing. Another subsequent surgery would be performed by 76.47%, with 66.67% planning to perform surgery without lymph node staging. 53.06% of respondents would follow up patients for five years. Percentages are reported based on the number of valid responses for each item. Conclusion This survey demonstrates differences in the clinical management of isolated STIC across German-speaking countries, highlighting discrepancies between guideline recommendations and real-world practices. This study is registered in the German Clinical Trials Register under DRKS00033112