评估风险减少手术（RRS）对生活质量（QoL）的影响，用于预防乳腺癌（BC）和卵巢癌（OC）。我们考虑风险减少乳房切除术（RRM），风险减少输卵管和卵巢切除术（RRSO）和风险减少早期输卵管切除和延迟卵巢切除（RRESDO）。我们遵循一个前瞻性协议（PROSPERO: CRD42022319782），并从开始到2023年2月搜寻MEDLINE、EMBASE、PubMed和Cochrane Library。我们遵循PICOS框架。人群包括有BC或OC风险的女性。我们重点研究了RRM用于BC和RRSO或RRESDO用于OC的RRS后报告QoL结果（与健康有关的QoL（HRQoL），性功能，更年期症状，身体形象，癌症相关困扰或担忧，焦虑或抑郁）。我们使用非随机研究的方法学指数（MINORS）进行研究评估。进行了定性综合和固定作用模型的荟萃分析。共包括34项研究（RRM：16项，RRSO：19项，RRESDO：2项）。在RRM后，15项研究中有13项（N = 986）HRQoL保持不变或改善，在RRSO后的16项研究中有10项发生改变（N = 1617），尽管存在短期缺陷（N = 96）。性功能（使用性活动问卷）在16项研究中受到影响（N = 1400），在性快感减少（-1.21 [-1.53，-0.89]；N = 3070）和性不适增加（1.12 [0.93,1.31]；N = 1400）方面发生了变化。绝经前RRSO后的激素替代疗法与性快感增加（1.16 [0.17,2.15]；N = 291）和性不适减少（-1.20 [-1.75，-0.65]；N = 157）相关。在13项RRM后的研究中，性功能在4项研究中受到影响（N = 147），但在9项研究中保持稳定（N = 799）。在7项研究中（N = 605）RRM后，身体形象保持不变，而6项研究（N = 391）报告恶化。在13项研究中（N = 1759）RRSO后，有12项报告更严重的更年期症状，但在癌症治疗功能评估量表内分值（-1.96 [-2.81，-1.10]；N = 1745）方面有所缓解。在5项RRM研究（N = 365）和10项RRSO研究（N = 1223）后，癌症相关困扰保持不变或减少。 RRESDO（2项研究，N = 413）具有更好的性功能和更好的更年期特异性QoL。RRS可能会影响QoL结果。 RRM和RRSO会减少癌症相关困扰，并不影响HRQoL。女性和临床医生应注意RRM后的身体形象问题，以及RRSO后的性功能障碍和更年期症状。 RRESDO可能是减轻RRSO相关QoL风险的有希望的选择。版权所有©2023作者。Elsevier Inc.保留所有权利。

To assess the impact of risk-reducing surgery (RRS) for breast cancer (BC) and ovarian cancer (OC) prevention on quality-of-life (QoL). We consider risk-reducing mastectomy (RRM), risk-reducing salpingo-oophorectomy (RRSO), and risk-reducing early-salpingectomy and delayed-oophorectomy (RRESDO).We followed a prospective protocol (PROSPERO: CRD42022319782) and searched MEDLINE, EMBASE, PubMed, and Cochrane Library from inception to February 2023.We followed a PICOS framework. The population included women at increased risk of BC or OC. We focused on studies reporting QoL outcomes (health-related QoL (HRQoL), sexual function, menopause symptoms, body image, cancer-related distress or worry, anxiety or depression) after RRS, including RRM for BC and RRSO or RRESDO for OC.We used the Methodological Index for Non-Randomized Studies (MINORS) for study appraisal. Qualitative synthesis and fixed-effects meta-analysis was performed.Thirty-four studies were included (RRM:16 studies, RRSO: 19 studies, RRESDO: 2 studies). HRQoL was unchanged or improved in 13/15 studies post-RRM (N=986) and 10/16 studies post-RRSO (N=1617), despite short-term deficits (N=96 post-RRM and N=459 post-RRSO). Sexual function (using Sexual Activity Questionnaire) was affected in 13/16 studies (N=1400) post-RRSO, in terms of decreased sexual pleasure (-1.21[-1.53,-0.89]; N=3070) and increased sexual discomfort (1.12[0.93,1.31]; N=1400). Hormone replacement therapy after pre-menopausal RRSO was associated with an increase (1.16[0.17,2.15]; N=291) in sexual pleasure and a decrease (-1.20[-1.75,-0.65]; N=157) in sexual discomfort. Sexual function was affected in 4/13 studies (N=147) post-RRM, but stable in 9/13 studies (N=799). Body image was unaffected in 7/13 studies (N=605) post-RRM, whereas 6/13 studies (N=391) reported worsening. Increased menopause symptoms were reported in 12/13 studies (N=1759) post-RRSO with a reduction (-1.96[-2.81,-1.10]; N=1745) in Functional Assessment of Cancer Therapy-Endocrine Subscale. Cancer-related distress was unchanged or decreased in 5/5 studies post-RRM (N=365) and 8/10 studies post-RRSO (N=1223). RRESDO (2 studies, N=413) had better sexual function and menopause-specific QoL.RRS may be associated with QoL outcomes. RRM and RRSO reduce cancer-related distress, and do not affect HRQoL. Women and clinicians should be aware of body image problems post-RRM, together-with sexual dysfunction and menopause symptoms post-RRSO. RRESDO may be a promising alternative to mitigate QoL-related risks of RRSO.Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.