Abstract
Among solid tumors afflicting women, ovarian cancer is umcommon, but is the second most common malignancy of the lower part of the female genital tract and is, inauspiciously, the most deadly. Reflecting its many epithelial and stromal components, ovarian cancer is a diverse set of histological subtypes and can be further annotated by unique molecular characteristics. The most common subtype is epithelial, which is believed to have a significant component of origin in the fallopian tube. In light of its anatomical location and absence of unique symptoms, ovarian cancer has been difficult to screen and, as such, is frequently diagnosed when the disease has spread via direct extension, peritoneal deposition, or lymphovascularly. Contemporary treatment paradigms utilize surgery, combination chemotherapy, and biological agents. Insight into genomic alterations such as mutations in the BRCA1/2 genes and global deficiency in homologous recombination have ushered in the poly-(ADP) ribose polymerase (PARP) inhibitors, which have demonstrated impressive effects in selected primary and recurrent patients. Rare subtypes, particularly those involving the germinal and stromal cells, can occur in younger patients and in many settings are curable, even with fertility preservation. As with most oncology, rapid discovery of key cancer-driving alterations is providing fertile soil for drug development with the hopes of improving survival and survivorship.
Original language | English (US) |
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Title of host publication | Comprehensive Gynecology |
Publisher | Elsevier |
Pages | 707 and 753.e7 |
ISBN (Electronic) | 9780323653992 |
DOIs | |
State | Published - Jan 1 2021 |
Keywords
- Adjuvant chemotherapy
- Anti-angiogenesis
- Bevacizumab
- Biomarkers
- BRCA mutation
- CA-125
- Carboplatin
- Clear cell cancer
- Disease surveillance
- Dysgerminomas
- Endometrioid cancer and low-grade serous carcinoma
- Epithelial tumors
- Fallopian tube cancer
- Family history
- Genetic testing
- Germ cell tumors
- Gonadoblastomas
- Granulosa cell tumors
- High-grade serous cancer
- Hormone therapy
- Hyperthermic intraperitoneal chemotherapy (HIPEC)
- Immature teratoma
- Immunotherapy
- Interval cytoreduction
- Malignant spread
- Minimally invasive surgery
- Mucinous cancer
- Neoadjuvant chemotherapy
- Next-generation tissue mutational sequencing
- Niraparib
- Olaparib
- Optimal debulking
- Ovarian cancer
- Ovarian cancer risk
- Paclitaxel
- Panel testing
- Pelvic mass
- Platinum-resistant recurrence
- Platinum-sensitive recurrence
- Poly-ADP ribose - polymerase (PARP) inhibitors
- Primary peritoneal cancer
- Risk-reducing surgery
- Rucaparib
- Secondary cytoreduction
- Sertoli-Leydig tumors
- Sex cord-stromal tumors
- Stage
- Surgical staging
- Veliparib
- Yolk sac tumors
ASJC Scopus subject areas
- Medicine(all)