The fallopian tube as origin of ovarian cancer: Change of diagnostic and preventive strategies

Abstract Ovarian cancer is the leading cause of gynecologic cancer death in the world, and its prevention and early diagnosis remain the key to its treatment, especially for high‐grade serous carcinoma (HGSC). Accumulating epidemiological and molecular evidence has shown that HGSC originates from fa...

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Main Authors: Satoru Kyo, Noriyoshi Ishikawa, Kohei Nakamura, Kentaro Nakayama
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Cancer Medicine
Subjects:
Online Access:https://doi.org/10.1002/cam4.2725
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author Satoru Kyo
Noriyoshi Ishikawa
Kohei Nakamura
Kentaro Nakayama
author_facet Satoru Kyo
Noriyoshi Ishikawa
Kohei Nakamura
Kentaro Nakayama
author_sort Satoru Kyo
collection DOAJ
description Abstract Ovarian cancer is the leading cause of gynecologic cancer death in the world, and its prevention and early diagnosis remain the key to its treatment, especially for high‐grade serous carcinoma (HGSC). Accumulating epidemiological and molecular evidence has shown that HGSC originates from fallopian tube secretory cells through serous tubal intraepithelial carcinoma. Comprehensive molecular analyses and mouse studies have uncovered the key driver events for serous carcinogenesis, providing novel molecular targets. Risk‐reducing bilateral salpingo‐oophorectomy (RRSO) has been proposed to reduce the subsequent occurrence of serous carcinoma in high‐risk patients with BRCA mutations. However, there is no management strategy for isolated precursors detected at RRSO, and the role of subsequent surgery or chemotherapy in preventing serous carcinoma remains unclear. Surgical menopause due to RRSO provides a variety of problems related to patients’ quality of life, and the risks and benefits of hormone replacement are under investigation, especially for women without a previous history of breast cancer. An additional surgical option, salpingectomy with delayed oophorectomy, has been proposed to prevent surgical menopause. The number of opportunistic salpingectomies at the time of surgery for benign disease to prevent the future occurrence of HGSC has increased worldwide. Thus, the changing concept of the origin of serous carcinoma has provided us a great opportunity to develop novel diagnostic and therapeutic approaches.
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spelling doaj-art-e9fe4533e54c42e69c7dfbc0cea2a2b22025-08-25T10:14:04ZengWileyCancer Medicine2045-76342020-01-019242143110.1002/cam4.2725The fallopian tube as origin of ovarian cancer: Change of diagnostic and preventive strategiesSatoru Kyo0Noriyoshi Ishikawa1Kohei Nakamura2Kentaro Nakayama3Department of Obstetrics and Gynecology Shimane University Faculty of Medicine Izumo Shimane JapanDepartment of Pathology Shimane University Faculty of Medicine Izumo Shimane JapanDepartment of Obstetrics and Gynecology Shimane University Faculty of Medicine Izumo Shimane JapanDepartment of Obstetrics and Gynecology Shimane University Faculty of Medicine Izumo Shimane JapanAbstract Ovarian cancer is the leading cause of gynecologic cancer death in the world, and its prevention and early diagnosis remain the key to its treatment, especially for high‐grade serous carcinoma (HGSC). Accumulating epidemiological and molecular evidence has shown that HGSC originates from fallopian tube secretory cells through serous tubal intraepithelial carcinoma. Comprehensive molecular analyses and mouse studies have uncovered the key driver events for serous carcinogenesis, providing novel molecular targets. Risk‐reducing bilateral salpingo‐oophorectomy (RRSO) has been proposed to reduce the subsequent occurrence of serous carcinoma in high‐risk patients with BRCA mutations. However, there is no management strategy for isolated precursors detected at RRSO, and the role of subsequent surgery or chemotherapy in preventing serous carcinoma remains unclear. Surgical menopause due to RRSO provides a variety of problems related to patients’ quality of life, and the risks and benefits of hormone replacement are under investigation, especially for women without a previous history of breast cancer. An additional surgical option, salpingectomy with delayed oophorectomy, has been proposed to prevent surgical menopause. The number of opportunistic salpingectomies at the time of surgery for benign disease to prevent the future occurrence of HGSC has increased worldwide. Thus, the changing concept of the origin of serous carcinoma has provided us a great opportunity to develop novel diagnostic and therapeutic approaches.https://doi.org/10.1002/cam4.2725BRCA mutationscancer biologycancer geneticsgynecological oncology
spellingShingle Satoru Kyo
Noriyoshi Ishikawa
Kohei Nakamura
Kentaro Nakayama
The fallopian tube as origin of ovarian cancer: Change of diagnostic and preventive strategies
Cancer Medicine
BRCA mutations
cancer biology
cancer genetics
gynecological oncology
title The fallopian tube as origin of ovarian cancer: Change of diagnostic and preventive strategies
title_full The fallopian tube as origin of ovarian cancer: Change of diagnostic and preventive strategies
title_fullStr The fallopian tube as origin of ovarian cancer: Change of diagnostic and preventive strategies
title_full_unstemmed The fallopian tube as origin of ovarian cancer: Change of diagnostic and preventive strategies
title_short The fallopian tube as origin of ovarian cancer: Change of diagnostic and preventive strategies
title_sort fallopian tube as origin of ovarian cancer change of diagnostic and preventive strategies
topic BRCA mutations
cancer biology
cancer genetics
gynecological oncology
url https://doi.org/10.1002/cam4.2725
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