Ovarian cancer

Elise C. Kohn, Jean Hurteau
2012 Cancer  
Epithelial ovarian cancer, once categorizing all epithelial cancers of the ovary and fallopian tube, is now recognized to be an umbrella term. We are recognizing two categories of ovarian cancer, with the "type 1" cancers containing further types, including low grade serous cancers, mucinous, clear cell, and low grade endometrioid. These types are genetically and histologically as different as is their outcome. The paper accompanying this editorial further dissects low grade serous cancers to
more » ... ow that those carrying oncogenic KRAS or BRAF mutations have an unexpectedly excellent clinical outcome. We discuss this newest unexpected behavior of ovarian cancer. Keywords ovarian cancer; KRAS; BRAF; serous; borderline tumor Once again we find epithelial ovarian cancer forging its own path rather than following the classical paths forged by other carcinomas. These classical paths describe carcinomas as having a select cell of origin, spreading by nodal extension and hematogenous dissemination, generally metastasizing to first encountered capillary beds, and more recently, having mutational activation of a signaling pathway that creates a dominant driving event. This dominant driving event portends poor outcome and, when interrupted therapeutically, results in clinical benefit. We are learning that what we have known as epithelial ovarian cancer is really a collection of cancers of Mullerian origin 1 . These Mullerian cancers shed into and spread within the peritoneal cavity long before lymphovascular dissemination, and their genetic and genomic events are varied.
doi:10.1002/cncr.27833 pmid:23233093 pmcid:PMC3553273 fatcat:tpxot242jzg43mvyedvw3o32oi