Overview of epithelial carcinoma of the ovary, fallopian tube, and peritoneum
- Lee-may Chen, MD
Lee-may Chen, MD
- Professor of Obstetrics, Gynecology, & Reproductive Sciences
- Division of Gynecologic Oncology
- UCSF Helen Diller Family Comprehensive Cancer Center
- Jonathan S Berek, MD, MMS
Jonathan S Berek, MD, MMS
- Laurie Kraus Lacob Professor
- Stanford University School of Medicine
- Fellow, Stanford Distinguished Careers Institute
- Director, Stanford Women's Cancer Center
- Senior Scientific Advisor, Stanford Cancer Institute
- Section Editors
- Barbara Goff, MD
Barbara Goff, MD
- Section Editor — Gynecologic Oncology
- Professor of Gynecologic Oncology
- University of Washington
- Don S Dizon, MD, FACP
Don S Dizon, MD, FACP
- Section Editor – Gynecologic Oncology
- Clinical Co-Director, Gynecologic Oncology
- Founder and Director, The Oncology Sexual Health Clinic
- Massachusetts General Hospital Cancer Center
- Associate Professor of Medicine
- Harvard Medical School
- Deputy Editors
- Sandy J Falk, MD, FACOG
Sandy J Falk, MD, FACOG
- Director, Editorial Relations — UpToDate
- Deputy Editor — Obstetrics, Gynecology and Women's Health
- Instructor of Obstetrics, Gynecology and Reproductive Biology, Part-time
- Harvard Medical School
- Sadhna R Vora, MD
Sadhna R Vora, MD
- Deputy Editor — Oncology
- Instructor in Medicine
- Harvard Medical School
Ovarian cancer is the second most common gynecologic malignancy in developed countries and the third most common gynecologic malignancy in developing countries (cervical cancer is the most common) . The majority of ovarian malignancies (95 percent) are epithelial; the remainder arise from other ovarian cell types (germ cell tumors, sex cord-stromal tumors) (figure 1).
High-grade serous carcinoma, the most common histologic subtype of epithelial ovarian carcinoma, is regarded as closely related to fallopian tube and peritoneal serous carcinoma, based upon similarities in histology and clinical behavior. Some experts have proposed that these carcinomas all originate in the fallopian tubes. Based upon their common features, these carcinomas will be discussed as one clinical entity and referred to as epithelial ovarian carcinoma (EOC) in this topic review. Distinctions between these conditions will also be addressed. (See "Pathogenesis of ovarian, fallopian tubal, and peritoneal serous carcinomas".)
An overview of EOC is presented here. Related topics are discussed in detail separately, including:
●Pathogenesis (see "Pathogenesis of ovarian, fallopian tubal, and peritoneal serous carcinomas")
●Histopathology (see "Epithelial carcinoma of the ovary, fallopian tube, and peritoneum: Histopathology")
- Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin 2015; 65:87.
- Lacey JV, Sherman ME. Ovarian neoplasia. In: Robboy's Pathology of the Female Reproductive Tract, 2nd ed., Robboy SL, Mutter GL, Prat J, et al. (Eds), Churchill Livingstone Elsevier, Oxford 2009. p.601.
- Ben-Baruch G, Sivan E, Moran O, et al. Primary peritoneal serous papillary carcinoma: a study of 25 cases and comparison with stage III-IV ovarian papillary serous carcinoma. Gynecol Oncol 1996; 60:393.
- Berek JS, Crum C, Friedlander M. Cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet 2012; 119 Suppl 2:S118.
- Siegel RL, Miller KD, Jemal A. Cancer Statistics, 2017. CA Cancer J Clin 2017; 67:7.
- https://seer.cancer.gov/statfacts/html/ovary.html (Accessed on July 25, 2017).
- Prat J, FIGO Committee on Gynecologic Oncology. Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet 2014; 124:1.
- Heintz AP, Odicino F, Maisonneuve P, et al. Carcinoma of the ovary. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer. Int J Gynaecol Obstet 2006; 95 Suppl 1:S161.
- Winter WE 3rd, Maxwell GL, Tian C, et al. Prognostic factors for stage III epithelial ovarian cancer: a Gynecologic Oncology Group Study. J Clin Oncol 2007; 25:3621.
- Hoskins WJ, Bundy BN, Thigpen JT, Omura GA. The influence of cytoreductive surgery on recurrence-free interval and survival in small-volume stage III epithelial ovarian cancer: a Gynecologic Oncology Group study. Gynecol Oncol 1992; 47:159.
- Crawford SC, Vasey PA, Paul J, et al. Does aggressive surgery only benefit patients with less advanced ovarian cancer? Results from an international comparison within the SCOTROC-1 Trial. J Clin Oncol 2005; 23:8802.
- Klar M, Hasenburg A, Hasanov M, et al. Prognostic factors in young ovarian cancer patients: An analysis of four prospective phase III intergroup trials of the AGO Study Group, GINECO and NSGO. Eur J Cancer 2016; 66:114.
- Berman ML. Future directions in the surgical management of ovarian cancer. Gynecol Oncol 2003; 90:S33.
- Aletti GD, Gostout BS, Podratz KC, Cliby WA. Ovarian cancer surgical resectability: relative impact of disease, patient status, and surgeon. Gynecol Oncol 2006; 100:33.
- Solomon LA, Munkarah AR, Schimp VL, et al. Maspin expression and localization impact on angiogenesis and prognosis in ovarian cancer. Gynecol Oncol 2006; 101:385.
- Zivanovic O, Sima CS, Iasonos A, et al. Exploratory analysis of serum CA-125 response to surgery and the risk of relapse in patients with FIGO stage IIIC ovarian cancer. Gynecol Oncol 2009; 115:209.
- Zhao D, Zhang F, Zhang W, et al. Prognostic role of hormone receptors in ovarian cancer: a systematic review and meta-analysis. Int J Gynecol Cancer 2013; 23:25.
- Cliby WA, Aletti GD, Wilson TO, Podratz KC. Is it justified to classify patients to Stage IIIC epithelial ovarian cancer based on nodal involvement only? Gynecol Oncol 2006; 103:797.
- Onda T, Yoshikawa H, Yasugi T, et al. Patients with ovarian carcinoma upstaged to stage III after systematic lymphadenctomy have similar survival to Stage I/II patients and superior survival to other Stage III patients. Cancer 1998; 83:1555.
- https://www.nccn.org/professionals/physician_gls/pdf/ovarian.pdf (Accessed on July 26, 2017).
- Limei Z, Yong C, Yan X, et al. Accuracy of positron emission tomography/computed tomography in the diagnosis and restaging for recurrent ovarian cancer: a meta-analysis. Int J Gynecol Cancer 2013; 23:598.
- EPIDEMIOLOGY AND RISK FACTORS
- CLINICAL PRESENTATION
- STAGING AND TREATMENT
- Staging and surgical treatment
- POSTTREATMENT SURVEILLANCE
- CA 125 surveillance
- No role for routine imaging
- RELAPSED DISEASE
- ISSUES IN SURVIVORS
- Fertility preservation
- Other posttreatment issues