Pathogenesis of ovarian cancer: current perspectives

Abstract

Objective: To present a review of current knowledge of the pathogenesis of ovarian cancer and its clinical implications.
Data Source: Extensive literature search was conducted to identify relevant studies.
Study Selection: Studies in the English language about or related to pathogenesis of ovarian cancer were selected.
Data Extraction: Applicable findings from selected studies were extracted as reported in the studies.
Data Synthesis: Proposed theories of pathogenesis, and source population of ovarian tumour cells are discussed, and classification of ovarian cancer presented. Clinical implications of these new insights are also presented. Traditionally, epithelial ovarian tumours are thought to arise from the ovarian surface epithelium. Proposed factors that drive ovarian tumourigenesis include incessant-ovulation, gonadotropin stimulation, inflammation, and hormonal stimulation. There is evidence suggesting that ovarian tumour cells arise from extra-ovarian sites with secondary involvement of the ovary; the most prevalent and aggressive histological type (serous tumours) being of tubal origin. Ovarian cancer is now classified as type I and II or type I, II and III on the basis of shared mutations, histogenetic pathways, and behaviour.
Conclusion: The pathogenesis of ovarian cancer has not been established. Adoption of extra-ovarian origin of tumour cells may have implications for prevention, screening, and treatment of ovarian cancer.

Key Words: Ovarian cancer, pathogenesis, Müllerian, extra- Müllerian, extra-ovarian, incessant-ovulation, ovarian surface epithelium, hormonal.