Low-Grade Serous Carcinoma of the Ovary: The Current Status

Abstract

Low-grade serous carcinoma (LGSC) of the ovary is a rare histological subtype of epithelial ovarian carcinoma. It has distinct clinical behavior and a specific molecular profile. Compared with high-grade serous carcinoma, this tumor presents at a younger age, has an indolent course, and is associated with prolonged survival. LGSC can arise de novo or originate following a serous borderline tumor (SBT). Pathological differentiation between LGSC and other ovarian carcinoma histological subtypes is fundamental. Several factors might influence the overall outcome, such as the age at diagnosis, current smoking, elevated body mass index, mutational status, hormonal receptors’ expression, and Ki-67 proliferation index. Surgery is the main treatment option in LGSC, and efforts must be maximized to achieve a microscopic residual in metastatic disease. Despite being relatively chemo-resistant, adjuvant platinum-based chemotherapy remains the standard of care in LGSC. Hormonal maintenance therapy after adjuvant chemotherapy results in improved outcomes. Treatment options for disease recurrence include secondary cytoreductive surgery, chemotherapy, hormonal therapy, targeted therapy, and clinical trials. Advancements in genomic studies and targeted therapies are expected to change the treatment landscape in LGSC.

A comprehensive investigation of histotype‐specific microRNA and their variants in Stage I epithelial ovarian cancers

“…While for HGSOC the tubal paradigm is the most plausible, the origin of LGSOC remains under debate, they are thought to arise from fallopian tubes or from the ovarian surface epithelium 40‐43 . To explore the similarity of the expression of HGSOC and LGSOC biomarkers with that in their putative tissue of origin, we exploited the data available from the OCaMIR signature 44 (GSE127873) where miRNA‐seq data have been generated for both healthy fallopian tubes and early stage ovarian tumor samples.…”

“…(C) Comparison between the expression of LGSOC markers in LGSOC samples, OCaMIR's HGSOC samples and healthy fallopian tubes. IsomiRs are shown along the Y axis, while the X axis represents the log expression fallopian tubes or from the ovarian surface epithelium [40][41][42][43]. To explore the similarity of the expression of HGSOC and LGSOC biomarkers with that in their putative tissue of origin, we exploited the data available from the OCaMIR signature44 (GSE127873) where miRNAseq data have been generated for both healthy fallopian tubes and early stage ovarian tumor samples.…”

Molecular characteristics and clinical behaviour of epithelial ovarian cancers

“…LGSOC are WT1 positive [3,12], are almost always ER positive, and express PR in a large proportion of cases [14,44]. LGSOC is frequently associated with serous borderline tumours, which are considered a common precursor lesion [45], with the LGSOC cell of origin thought to initially derive from the fallopian tube [39]. Limited available expression data support the notion of a fallopian tube origin for LGSOC [46], though our current understanding of LGSOC pathogenesis is incomplete.…”

Circular RNAs in Epithelial Ovarian Cancer: From Biomarkers to Therapeutic Targets

“…Unlike HGSC, mutations of KRAS , HER2 , BRAF , and NRAS genes are frequently identified in LGSC [ 15 , 23 ]. LGSC patients are typically younger and are resistant to paclitaxel (PTX) and carboplatin drugs, while they are more susceptible to etoposide and doxorubicin-based treatments [ 24 , 25 ].…”