Ovarian cancer: Epidemiology, biology, and prognostic factors

Abstract

Ovarian cancer varies widely in frequency among different geographic regions and ethnic groups, with a high incidence in Northern Europe and the United States, and a low incidence in Japan. The majority of cases are sporadic, and only 5% to 10% of ovarian cancers are familial. The etiology of ovarian cancer is poorly understood. Models of ovarian carcinogenesis include the theory of incessant ovulation, in which a person's age at ovulation, i.e., lifetime number of ovulatory cycles, is an index of her ovarian cancer risk. Excessive gonadotropin and androgen stimulation of the ovary have been postulated as contributing factors. Exposure of the ovaries to pelvic contaminants and carcinogens may play a role in the pathogenesis of ovarian cancer. Epidemiologic and molecular‐genetic studies identify numerous risk and protective factors. The most significant risk factor is a family history of the disease. Recent advances in molecular genetics have found mutations in the BRCA1 and BRCA2 tumor suppressor genes responsible for the majority of hereditary ovarian cancer. Additional risk factors include nulliparity and refractory infertility. Protective factors include multiparity, oral contraceptives, and tubal ligation or hysterectomy. With five years of oral contraceptive use, women can cut their risk of ovarian cancer approximately in half; this also holds true for individuals with a family history. Stage at diagnosis, maximum residual disease following cytoreductive surgery, and performance status are the three major prognostic factors. Using a multimodality approach to treatment, including aggressive cytoreductive surgery and combination chemotherapy, five‐year survival rates are as follows: Stage I (93%), Stage II (70%), Stage III (37%), and Stage IV (25%). Semin. Surg. Oncol. 19:3–10, 2000. © 2000 Wiley‐Liss, Inc.

Methylation status of TUSC3 is a prognostic factor in ovarian cancer

“…31,32 By using publicly available gene-expression profiling data, we have systematically screened the region on 8p22 for differentially regulated genes and identified TUSC3 as a candidate tumor suppressor gene in ovarian cancer. 14 In our current work, we validate our previous observations in a larger, completely independent patient population and demonstrate that the expression of TUSC3 in ovarian cancer may be regulated by promoter methylation.…”

Incidence and mortality in epithelial ovarian cancer by family history of any cancer

“…4 Known risk/protective factors of ovarian cancer are reproductive and hormonal factors and family history. [5][6][7][8][9] A previous Swedish study estimated population-attributable fractions for epithelial ovarian cancer and found the highest contribution of 22.3% for reproductive factors, well above 2.6% for family history. 10 In population-based studies with medically verified diagnosis, the familial risk of invasive ovarian cancer has ranged between 2.0 and 3.0.…”

Immunohistochemical analysis of possible chemoresistance markers identified by micro-arrays on serous ovarian carcinomas

“…1 An initial surgical approach is essential for aggressive cytoreduction and proper staging of the disease, since minimal residual tumor after surgery is a major factor of better response to chemotherapy and survival. 2 Intravenous combinated chemotherapy with taxol plus carboplatin is the current regimen of choice for the treatment of advanced ovarian cancer and is followed by a 50% complete pathologic remission rate.…”