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Ovarian cancer

MedGen UID:
216027
Concept ID:
C1140680
Neoplastic Process
Synonym: OVARIAN CANCER, SOMATIC
SNOMED CT: CA - Cancer of ovary (363443007); Cancer of ovary (363443007); Ovarian cancer (363443007); Malignant tumor of ovary (363443007)
 
Monarch Initiative: MONDO:0008170
OMIM®: 167000
Orphanet: ORPHA213500

Definition

Ovarian cancer, the leading cause of death from gynecologic malignancy, is characterized by advanced presentation with loco-regional dissemination in the peritoneal cavity and the rare incidence of visceral metastases (Chi et al., 2001). These typical features relate to the biology of the disease, which is a principal determinant of outcome (Auersperg et al., 2001). Epithelial ovarian cancer is the most common form and encompasses 5 major histologic subtypes: papillary serous, endometrioid, mucinous, clear cell, and transitional cell. Epithelial ovarian cancer arises as a result of genetic alterations sustained by the ovarian surface epithelium (Stany et al., 2008; Soslow, 2008). [from OMIM]

Additional description

From MedlinePlus Genetics
Ovarian cancer is a disease that affects women. In this form of cancer, certain cells in the ovary become abnormal and multiply uncontrollably to form a tumor. The ovaries are the female reproductive organs in which egg cells are produced. In about 90 percent of cases, ovarian cancer occurs after age 40, and most cases occur after age 60.

The most common form of ovarian cancer begins in epithelial cells, which are the cells that line the surfaces and cavities of the body. These cancers can arise in the epithelial cells on the surface of the ovary. However, researchers suggest that many or even most ovarian cancers begin in epithelial cells on the fringes (fimbriae) at the end of one of the fallopian tubes, and the cancerous cells migrate to the ovary.

Cancer can also begin in epithelial cells that form the lining of the abdomen (the peritoneum). This form of cancer, called primary peritoneal cancer, resembles epithelial ovarian cancer in its origin, symptoms, progression, and treatment. Primary peritoneal cancer often spreads to the ovaries. It can also occur even if the ovaries have been removed. Because cancers that begin in the ovaries, fallopian tubes, and peritoneum are so similar and spread easily from one of these structures to the others, they are often difficult to distinguish. These cancers are so closely related that they are generally considered collectively by experts.

In about 10 percent of cases, ovarian cancer develops not in epithelial cells but in germ cells, which are precursors to egg cells, or in hormone-producing ovarian cells called granulosa cells.

In its early stages, ovarian cancer usually does not cause noticeable symptoms. As the cancer progresses, signs and symptoms can include pain or a feeling of heaviness in the pelvis or lower abdomen, bloating, feeling full quickly when eating, back pain, vaginal bleeding between menstrual periods or after menopause, or changes in urinary or bowel habits. However, these changes can occur as part of many different conditions. Having one or more of these symptoms does not mean that a woman has ovarian cancer.

In some cases, cancerous tumors can invade surrounding tissue and spread to other parts of the body. If ovarian cancer spreads, cancerous tumors most often appear in the abdominal cavity or on the surfaces of nearby organs such as the bladder or colon. Tumors that begin at one site and then spread to other areas of the body are called metastatic cancers.

Some ovarian cancers cluster in families. These cancers are described as hereditary and are associated with inherited gene mutations. Hereditary ovarian cancers tend to develop earlier in life than non-inherited (sporadic) cases.

Because it is often diagnosed at a late stage, ovarian cancer can be difficult to treat; it leads to the deaths of about 14,000 women annually in the United States, more than any other gynecological cancer. However, when it is diagnosed and treated early, the 5-year survival rate is high.  https://medlineplus.gov/genetics/condition/ovarian-cancer

Clinical features

From HPO
Dysgerminoma
MedGen UID:
41680
Concept ID:
C0013377
Neoplastic Process
The presence of a dysgerminoma, i.e., an undifferentiated germ cell tumor of the ovary.
Ovarian papillary adenocarcinoma
MedGen UID:
870531
Concept ID:
C4024979
Neoplastic Process
The presence of a papillary adenocarcinoma of the ovary.
Breast carcinoma
MedGen UID:
146260
Concept ID:
C0678222
Neoplastic Process
The presence of a carcinoma of the breast.

Term Hierarchy

Professional guidelines

PubMed

Vergote I, Gonzalez-Martin A, Lorusso D, Gourley C, Mirza MR, Kurtz JE, Okamoto A, Moore K, Kridelka F, McNeish I, Reuss A, Votan B, du Bois A, Mahner S, Ray-Coquard I, Kohn EC, Berek JS, Tan DSP, Colombo N, Zang R, Concin N, O'Donnell D, Rauh-Hain A, Herrington CS, Marth C, Poveda A, Fujiwara K, Stuart GCE, Oza AM, Bookman MA; participants of the 6th Gynecologic Cancer InterGroup (GCIG) Ovarian Cancer Consensus Conference on Clinical Research
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Curated

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer, 2024

UK NICE Clinical guideline (CG122), Ovarian cancer: recognition and initial management, 2023

Recent clinical studies

Etiology

Sideris M, Menon U, Manchanda R
Med J Aust 2024 Mar 18;220(5):264-274. Epub 2024 Feb 14 doi: 10.5694/mja2.52227. PMID: 38353066
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Int J Cancer 2022 Nov 1;151(9):1535-1541. Epub 2022 Mar 30 doi: 10.1002/ijc.34002. PMID: 35322413
Forstner R
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Stewart C, Ralyea C, Lockwood S
Semin Oncol Nurs 2019 Apr;35(2):151-156. Epub 2019 Mar 11 doi: 10.1016/j.soncn.2019.02.001. PMID: 30867104

Diagnosis

Zhang R, Siu MKY, Ngan HYS, Chan KKL
Int J Mol Sci 2022 Oct 10;23(19) doi: 10.3390/ijms231912041. PMID: 36233339Free PMC Article
O'Shea AS
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Stewart C, Ralyea C, Lockwood S
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Therapy

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Seiden MV
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Prognosis

Owens L, Gogebakan KC, Menon U, Gulati R, Weiss NS, Etzioni R
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Curr Opin Obstet Gynecol 1998 Feb;10(1):51-5. doi: 10.1097/00001703-199802000-00010. PMID: 9484630

Clinical prediction guides

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Recent systematic reviews

Kahn RM, Gordhandas S, Godwin K, Stone RL, Worley MJ Jr, Lu KH, Long Roche KC
JAMA Surg 2023 Nov 1;158(11):1204-1211. doi: 10.1001/jamasurg.2023.4164. PMID: 37672283Free PMC Article
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Akazawa M, Hashimoto K
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Huber D, Seitz S, Kast K, Emons G, Ortmann O
Arch Gynecol Obstet 2020 Apr;301(4):875-884. Epub 2020 Mar 5 doi: 10.1007/s00404-020-05458-w. PMID: 32140806Free PMC Article
Konstantinopoulos PA, Norquist B, Lacchetti C, Armstrong D, Grisham RN, Goodfellow PJ, Kohn EC, Levine DA, Liu JF, Lu KH, Sparacio D, Annunziata CM
J Clin Oncol 2020 Apr 10;38(11):1222-1245. Epub 2020 Jan 27 doi: 10.1200/JCO.19.02960. PMID: 31986064Free PMC Article

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Curated

    • NCCN, 2024
      NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), Ovarian Cancer Including Fallopian Tube Cancer and Primary Peritoneal Cancer, 2024
    • NICE, 2023
      UK NICE Clinical guideline (CG122), Ovarian cancer: recognition and initial management, 2023

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