Natural history and outcome of mucinous carcinoma of the ovary

Schiavone, Maria B.; Herzog, Thomas J.; Lewin, Sharyn N.; Deutsch, Israel; Sun, Xuming; Burke, William M.; Wright, Jason D.

doi:10.1016/j.ajog.2011.06.049

Cited by 93 publications

(84 citation statements)

References 25 publications

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“…MC is diagnosed in approximately 11-14% of ovarian carcinomas [104,105]. MC is more frequently found in an early stage of disease and is associated with a better survival than NMC [106][107][108]. Compared with CRC, the ovarian variant of MC is an ill-defined entity and is usually classified as MC when the tumour has an 'intestinal' or 'cervical gland-like' phenotype.…”

Section: Mucinous Ovarian Carcinomamentioning

confidence: 99%

The molecular background of mucinous carcinoma beyond MUC2

Hugen

Simons²,

Halilović³

et al. 2014

Clin J Pathol

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The increasing interest of the oncology community in tumour classification and prediction of outcome to targeted therapies has put emphasis on an improved identification of tumour types. Colorectal mucinous adenocarcinoma (MC) is a subtype that is characterized by the presence of abundant extracellular mucin that comprises at least 50% of the tumour volume and is found in 10-15% of colorectal cancer patients. MC development is poorly understood, however, the distinct clinical and pathological presentation of MC suggests a deviant development and molecular background. In this review we identify common molecular and genetic alterations in colorectal MC. MC is characterized by a high rate of MUC2 expression. Mutation rates in the therapeutically important RAS/RAF/MAPK and PI3K/AKT pathways are significantly higher in MC compared with non-mucinous adenocarcinoma. Furthermore, mucinous adenocarcinoma shows higher rates of microsatellite instability and is more frequently of the CpG island methylator phenotype. Although the majority of MCs arise from the large intestine, this subtype also develops in other organs, such as the stomach, pancreas, biliary tract, ovary, breast and lung. We compared findings from colorectal MC with tumour characteristics of MCs from other organs. In these organs, MCs show different mutation rates in the RAS/RAF/MAPK and PI3K/ AKT pathways as well, but a common mucinous pathway cannot be identified. Identification of conditions and molecular aberrations that are associated with MC generates insight into the aetiology of this subtype and improves understanding of resistance to therapies.

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Section: Mucinous Ovarian Carcinomamentioning

confidence: 99%

The molecular background of mucinous carcinoma beyond MUC2

Hugen

Simons²,

Halilović³

et al. 2014

Clin J Pathol

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“…As previously mentioned, mEOC is more likely to diagnosed at an earlier stage and lower grade compared with HGSOC [6, 7,12]. Stage I mEOC has an excellent prognosis with 5 year survival of 90% with surgery alone, which is comparable if not superior to HGSOC [6,8,58]. Conversely, in the advanced disease setting, a number of studies have consistently demonstrated markedly inferior outcomes for mEOC compared with HGSOC, when treated with platinum-based chemotherapy both in the first-line, as well as the recurrent setting (table 5).…”

Section: Clinical Management and Pitfallsmentioning

confidence: 52%

Mucinous ovarian cancer: A therapeutic review

Wen

Rush

Rickett

et al. 2016

Critical Reviews in Oncology/Hematology

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Highlights Mucinous epithelial ovarian cancer (mEOC) is a rare chemo-resistant subtype of ovarian cancer with distinct epidemiology, pathology and natural history.  mEOC can often masquerade as metastatic mucinous tumours from the gastrointestinal (GI) tract.  Molecularly, in contrast to high-grade serous ovarian cancer (HGSOC), mEOC are far less defined by p53 mutations and instead commonly harbour KRAS and HER 2 mutations.  The current gold standard of 1 st line platinum/taxane doublet chemotherapy, is more tailored towards HGSOC and generally ineffective for mEOC.  This review summarises the limited evidence for using GI style chemotherapeutic agents in treating mEOC and explores novel therapeutic possibilities such as targeting HER2, VEGF and Src. AbstractMucinous ovarian cancer represents approximately 3% of epithelial ovarian cancers (EOC).Despite this seemingly low prevalence, it remains a diagnostic and therapeutic conundrum that has resulted in numerous attempts to adopt novel strategies in managing this disease.Anecdotally, there has been a prevailing notion that established gold standard systemic regimens should be substituted for those utilised in cancers such as gastrointestinal (GI) malignancies; tumours that share more biological similarities than other EOC subtypes. This review summarises the plethora of small studies which have adopted this philosophy and influenced the design of the multinational GOG142 study, which was ultimately terminated due to poor accrual. To date, there is a paucity of evidence to support delivering 'GI style' chemotherapy for mucinous ovarian cancer over and above carboplatin-paclitaxel doublet therapy. Hence there is an urge to develop studies focused on targeted therapeutic agents driven by refined mutational analysis and conducted within the context of harmonised international collaborations.3

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“…Thus, confining analysis to patients with a stage I mucinous tumor, a comparatively favorable prognosis was noted, despite the fact that an advanced mucinous tumor shows a poor response to platinum-based chemotherapy and an unfavorable clinical outcome [29,30]. Indeed, according to an earlier report, the 5-year disease-free survival rate of 410 patients with mucinous tumor was 90.8%, and this pathological type was not a significant prognostic factor on multivariate analysis [12,24,31]. However, in our current analysis, once patients with a mucinous tumor experienced recurrence, the 3-and 5-year survival rates after recurrence were 27.7 and 0%, respectively, being extremely poor.…”

Section: Commentsmentioning

confidence: 91%

“…Our regional population-based analysis revealed that the postrecurrence survival of patients with the mucinous/clearcell histology was significantly poorer than that of those with other histological types, such as a serous and endometrioid histology (P = 0.0253). Invasive mucinous tumors tend to occur in younger women and are commonly diagnosed at an earlier stage than serous neoplasms [24]. In addition, this type of tumor was more frequently of a lower grade [25][26][27][28].…”

Section: Commentsmentioning

confidence: 99%