A Review of the Clinical Characteristics and Novel Molecular Subtypes of Endometrioid Ovarian Cancer

Abstract

Ovarian cancer is one of the most common gynecologic cancers that has the highest mortality rate. Endometrioid ovarian cancer, a distinct subtype of epithelial ovarian cancer, is associated with endometriosis and Lynch syndrome, and is often accompanied by synchronous endometrial carcinoma. In recent years, dysbiosis of the microbiota within the female reproductive tract has been suggested to be involved in the pathogenesis of endometrial cancer and ovarian cancer, with some specific pathogens exhibiting oncogenic having been found to contribute to cancer development. It has been shown that dysregulation of the microenvironment and accumulation of mutations are stimulatory factors in the progression of endometrioid ovarian carcinoma. This would be a potential therapeutic target in the future. Simultaneously, multiple studies have demonstrated the role of four molecular subtypes of endometrioid ovarian cancer, which are of particular importance in the prediction of prognosis. This literature review aims to compile the potential mechanisms of endometrioid ovarian cancer, molecular characteristics, and molecular pathological types that could potentially play a role in the prediction of prognosis, and the novel therapeutic strategies, providing some guidance for the stratified management of ovarian cancer.

Progression Free Survival, Overall Survival, and Relapse Rate in Endometrioid Ovarian Cancer and Synchronous Endometrial-Ovarian Endometrioid Cancer (SEO-EC): Results from a Large Retrospective Analysis

“…As secondary outcome, we assessed the relapse rate in women who underwent systematic pelvic and para-aortic lymphadenectomy and women who did not undergo the same procedure. In our series, diagnosis and treatment was done at early stages in 97.6% of the cases, thus allowing good PFS and OS, confirming the endometrioid biological behavior [13]. In addition, we did not find significant differences (p = 0.6570) for the relapse rate, with or without systematic pelvic and para-aortic lymphadenectomy.…”

Identification and clinical significance of somatic oncogenic mutations in epithelial ovarian cancer

“…Type I cancers include low-grade serous cancer, endometrioid cancer, mucinous cancer, and clear cell cancer, which harbor somatic mutations such as BRAF , KRAS and PTEN , often with microsatellite instability (MSI). They are characterized by an indolent behavior diagnosed in early-stage, and arise in a stepwise process from borderline neoplasms [ 5 – 7 ]. Type II cancers are clinically aggressive and comprise high-grade serous carcinoma (HG-SC), carcinosarcomas, and undifferentiated carcinomas, which are associated with mutations in TP53 and BRCA1/2 [ 4 , 5 ].…”

Endometrial cancer with concomitant endometriosis is highly associated with ovarian endometrioid carcinoma: a retrospective cohort study

“…To elucidate the pathogenesis of EAOCs, further research is warranted to investigate the molecular changes in pathologically normal uterine endometrium of patients with EAOCs. Third, there are ovarian endometrioid carcinomas that are not associated with ovarian endometriosis [30,31]; therefore, the hypothesis that ovarian endometrioid carcinoma is arising from endometriosis from the abnormal uterine endometrium might be applied to only a part of ovarian endometrioid carcinomas. Further pathological and genomic analyses are needed to classify the pathogenesis of ovarian endometrioid carcinoma.…”