Download PDF
CC BY-NC-ND 4.0 · Geburtshilfe Frauenheilkd 2018; 78(10): 972-976
DOI: 10.1055/a-0717-5411
GebFra Science
Review
Georg Thieme Verlag KG Stuttgart · New York

Low-grade Serous Ovarian Carcinoma

Low-grade seröse Ovarialkarzinome
Enzo Ricciardi   *
1   Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany
,
Thaïs Baert   *
1   Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany
2   Department of Oncology, Laboratory of Tumor Immunology and Immunotherapy, ImmunOvar Research Group, KU Leuven, Leuven, Belgium
,
Beyhan Ataseven
1   Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany
,
Florian Heitz
1   Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany
,
Sonia Prader
1   Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany
,
Mareike Bommert
1   Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany
,
Stephanie Schneider
1   Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany
,
Andreas du Bois
1   Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany
,
Philipp Harter
1   Gynaecology and Gynaecological Oncology, Kliniken Essen-Mitte, Essen, Germany
› Author Affiliations
Further Information

Publication History

received 14 August 2018
revised 24 August 2018

accepted 26 August 2018

Publication Date:
19 October 2018 (online)

Also available at
   Permissions and Reprints

Abstract

In the early 2000s a two-tier grading system was introduced for serous ovarian cancer. Since then, we have increasingly come to accept that low-grade serous ovarian carcinoma (LGSOC) is a separate entity with a unique mutational landscape and clinical behaviour. As less than 10% of serous carcinomas of the ovary are low-grade, they are present in only a small number of patients in clinical trials for ovarian cancer. Therefore the current treatment of LGSOC is based on smaller trials, retrospective series, and subgroup analysis of large clinical trials on ovarian cancer. Surgery plays a major role in the treatment of patients with LGSOC. In the systemic treatment of LGSOC, hormonal treatment and targeted therapies seem to play an important role.

Zusammenfassung

Kurz nach der Jahrtausendwende wurde ein 2-stufiges Klassifizierungssystem zur Einstufung von serösen Ovarialkarzinomen eingeführt. Seither wird zunehmend akzeptiert, dass das Low-grade seröse Ovarialkarzinom (LGSOC) eine eigenständige Einheit mit eigener Mutationslandschaft und klinischem Verhalten bildet. Weniger als 10% aller serösen Karzinome des Ovars werden dem Low-Grade-Subtyp zugeordnet, und in den klinischen Studien zum Ovarialkrebs tritt diese Form nur in wenigen Patientinnen auf. Die aktuelle Therapie für das LGSOC basiert daher auf den Ergebnissen kleinerer Studien und retrospektiver Serien sowie auf der Subgruppenanalyse von großen klinischen Studien zum Ovarialkarzinom. Die operative Therapie spielt eine wichtige Rolle für die Behandlung von Patientinnen mit LGSOC. Bei der systemischen Therapie des LGSOC scheinen sowohl hormonelle Therapien als auch gezielte Therapien eine wichtige Rolle zu spielen.

Key words

ovarian cancer - low-grade serous - rare tumour

Schlüsselwörter

Ovarialkarzinom - Low-grade serös - seltener Tumor

* The authors equally contributed to the paper.


 

  • References

  • 1 Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J. et al. Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. Eur J Cancer 2013; 49: 1374-1403 doi:10.1016/j.ejca.2012.12.027
    CrossrefPubMedGoogle Scholar
  • 2 Kurman R, Ellenson LH, Ronnett BM. Blausteinʼs Pathology of the female genital Tract. 6th ed. Berlin, Heidelberg: Springer; 2011
    Google Scholar
  • 3 Malpica A, Deavers MT, Lu K. et al. Grading ovarian serous carcinoma using a two-tier system. Am J Surg Pathol 2004; 28: 496-504
    CrossrefPubMedGoogle Scholar
  • 4 Kaldawy A, Segev Y, Lavie O. et al. Low-grade serous ovarian cancer: A review. Gynecol Oncol 2016; 143: 433-438 doi:10.1016/j.ygyno.2016.08.320
    CrossrefPubMedGoogle Scholar
  • 5 Gershenson DM, Bodurka DC, Lu KH. et al. Impact of age and primary disease site on outcome in women with low-grade serous carcinoma of the ovary or peritoneum: Results of a large single-institution registry of a rare tumor. J Clin Oncol 2015; 33: 2675-2682
    CrossrefPubMedGoogle Scholar
  • 6 Peres LC, Cushing-Haugen KL, Köbel M. et al. Invasive Epithelial Ovarian Cancer Survival by Histotype and Disease Stage. J Natl Cancer Inst 2018; DOI: 10.1093/jnci/djy071.
    CrossrefPubMedGoogle Scholar
  • 7 Gershenson DM, Sun CC, Wong KK. Impact of mutational status on survival in low-grade serous carcinoma of the ovary or peritoneum. Br J Cancer 2015; 113: 1254-1258 doi:10.1038/bjc.2015.364
    CrossrefPubMedGoogle Scholar
  • 8 Wong KK, Gershenson D. The continuum of serous ovarian tumors of low malignant potential and low-grade serous carcinoma of the ovary. Dis Markers 2007; 23: 377-387
    CrossrefPubMedGoogle Scholar
  • 9 Bonome T, Lee JY, Park DC. et al. Expression profiling of serous low malignant potential, low-grade, and high-grade tumors of the ovary. Cancer Res 2005; 65: 10602-10612
    CrossrefPubMedGoogle Scholar
  • 10 Hauptmann S, Friedrich K, Redline R. et al. Ovarian borderline tumors in the 2014 WHO classification: evolving concepts and diagnostic criteria. Virchows Arch 2017; 470: 125-142
    CrossrefPubMedGoogle Scholar
  • 11 Kurman RJ, Shih IM. The origin and pathogenesis of epithelial ovarian cancer: A proposed unifying theory. Am J Surg Pathol 2010; 34: 433-443
    CrossrefPubMedGoogle Scholar
  • 12 Wong KK, Tsang YTM, Deavers MT. et al. BRAF mutation is rare in advanced-stage low-grade ovarian serous carcinomas. Am J Pathol 2010; 177: 1611-1617 doi:10.2353/ajpath.2010.100212
    CrossrefPubMedGoogle Scholar
  • 13 Kuo KT, Guan B, Feng Y. et al. Analysis of DNA copy number alterations in ovarian serous tumors identifies new molecular genetic changes in low-grade and high-grade carcinomas. Cancer Res 2009; 69: 4036-4042 doi:10.1158/0008-5472.CAN-08-3913
    CrossrefPubMedGoogle Scholar
  • 14 Wong KK, Lu KH, Malpica A. et al. Significantly greater expression of ER, PR, and ECAD in advanced-stage low-grade ovarian serous carcinoma as revealed by immunohistochemical analysis. Int J Gynecol Pathol 2007; 26: 404-409
    CrossrefPubMedGoogle Scholar
  • 15 Norquist BM, Harrell MI, Brady MF. et al. Inherited mutations in women with ovarian carcinoma. JAMA Oncol 2016; 2: 482-490
    CrossrefPubMedGoogle Scholar
  • 16 Fader AN, Java J, Ueda S. et al. Survival in women with grade 1 serous ovarian carcinoma. Obstet Gynecol 2013; 122: 225-232
    CrossrefPubMedGoogle Scholar
  • 17 Grabowski JP, Harter P, Heitz F. et al. Operability and chemotherapy responsiveness in advanced low-grade serous ovarian cancer. An analysis of the AGO Study Group metadatabase. Gynecol Oncol 2016; 140: 457-462
    CrossrefPubMedGoogle Scholar
  • 18 Fader AN, Bergstrom J, Jernigan A. et al. Primary cytoreductive surgery and adjuvant hormonal monotherapy in women with advanced low-grade serous ovarian carcinoma: Reducing overtreatment without compromising survival?. Gynecol Oncol 2017; 147: 85-91 doi:10.1016/j.ygyno.2017.07.127
    CrossrefPubMedGoogle Scholar
  • 19 Gershenson DM, Sun CC, Lu KH. et al. Clinical behavior of stage II–IV low-grade serous carcinoma of the ovary. Obstet Gynecol 2006; 108: 361-368
    CrossrefPubMedGoogle Scholar
  • 20 Ledermann JA, Raja FA, Fotopoulou C. et al. Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 2013; DOI: 10.1093/annonc/mdt333.
    CrossrefPubMedGoogle Scholar
  • 21 Gershenson DM, Sun CC, Bodurka D. et al. Recurrent low-grade serous ovarian carcinoma is relatively chemoresistant. Gynecol Oncol 2009; 114: 48-52 doi:10.1016/j.ygyno.2009.03.001
    CrossrefPubMedGoogle Scholar
  • 22 Schmeler KM, Sun CC, Bodurka DC. et al. Neoadjuvant chemotherapy for low-grade serous carcinoma of the ovary or peritoneum. Gynecol Oncol 2008; 108: 510-514
    CrossrefPubMedGoogle Scholar
  • 23 Oza AM, Cook AD, Pfisterer J. et al. Standard chemotherapy with or without bevacizumab for women with newly diagnosed ovarian cancer (ICON7): overall survival results of a phase 3 randomised trial. Lancet Oncol 2015; 16: 928-936
    CrossrefPubMedGoogle Scholar
  • 24 Gershenson DM, Bodurka DC, Coleman RL. et al. Hormonal maintenance therapy for women with low-grade serous cancer of the ovary or peritoneum. J Clin Oncol 2017; 35: 1103-1111
    CrossrefPubMedGoogle Scholar
  • 25 Gordon AN, Fleagle JT, Guthrie D. et al. Recurrent Epithelial Ovarian Carcinoma: A Randomized Phase III Study of Pegylated Liposomal Doxorubicin Versus Topotecan. J Clin Oncol 2001; 19: 3312-3322 doi:10.1200/JCO.2001.19.14.3312
    CrossrefPubMedGoogle Scholar
  • 26 Gershenson DM. Low-grade serous carcinoma of the ovary or peritoneum. Ann Oncol 2016; 27: i45-i49
    CrossrefPubMedGoogle Scholar
  • 27 du Bois A, Vergote I, Ferron G. et al. Randomized controlled phase III study evaluating the impact of secondary cytoreductive surgery in recurrent ovarian cancer: AGO DESKTOP III/ENGOT ov20. J Clin Oncol 2017; 35: 5501 doi:10.1200/JCO.2017.35.15_suppl.5501
    CrossrefPubMedGoogle Scholar
  • 28 Crane EK, Sun CC, Ramirez PT. et al. The role of secondary cytoreduction in low-grade serous ovarian cancer or peritoneal cancer. Gynecol Oncol 2015; 136: 25-29 doi:10.1016/j.ygyno.2014.11.005
    CrossrefPubMedGoogle Scholar
  • 29 Rose PG, Radeva M, Michener CM. et al. Efficacy of pegylated liposomal doxorubicin in low-grade serous ovarian carcinoma. Int J Gynecol Cancer 2017; 27: 907-911 doi:10.1016/j.ygyno.2017.03.497
    CrossrefPubMedGoogle Scholar
  • 30 Pujade-Lauraine E, Ledermann JA, Selle F. et al. Olaparib tablets as maintenance therapy in patients with platinum-sensitive, relapsed ovarian cancer and a BRCA1/2 mutation (SOLO2/ENGOT-Ov21): a double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Oncol 2017; 18: 1274-1284
    CrossrefPubMedGoogle Scholar
  • 31 Mirza MR, Monk BJ, Herrstedt J. et al. ENGOT-OV16/NOVA Investigators. Niraparib Maintenance Therapy in Platinum-Sensitive, Recurrent Ovarian Cancer. N Engl J Med 2016; 375: 2154-2164 doi:10.1056/NEJMoa1611310
    CrossrefPubMedGoogle Scholar
  • 32 Coleman RL, Oza AM, Lorusso D. et al. Rucaparib maintenance treatment for recurrent ovarian carcinoma after response to platinum therapy (ARIEL3): a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet 2017; 390: 1949-1961
    CrossrefPubMedGoogle Scholar
  • 33 Schmeler K, Tao X, Sun C. et al. Encouraging responses with bevacizumab in recurrent low-grade serous ovarian cancer. J Clin Oncol 2010; 28 (Suppl. 15) e15503 doi:10.1200/jco.2010.28.15_suppl.e15503
    CrossrefPubMedGoogle Scholar
  • 34 Dalton HJ, Fleming ND, Sun CC. et al. Activity of bevacizumab-containing regimens in recurrent low-grade serous ovarian or peritoneal cancer: A single institution experience. Gynecol Oncol 2017; 145: 37-40 doi:10.1016/j.ygyno.2017.01.027
    CrossrefPubMedGoogle Scholar
  • 35 Rose PG, Mahdi H, Jernigan A. et al. Activity of Bevacizumab in Patients with Low-Grade Serous Ovarian Carcinoma. Int J Gynecol Cancer 2016; 26: 1048-1052
    CrossrefPubMedGoogle Scholar
  • 36 Grisham RN, Iyer G, Sala E. et al. Bevacizumab shows activity in patients with low-grade serous ovarian and primary peritoneal cancer. Int J Gynecol Cancer 2014; 24: 1010-1014
    CrossrefPubMedGoogle Scholar
  • 37 Gershenson DM, Sun CC, Iyer RB. et al. Hormonal therapy for recurrent low-grade serous carcinoma of the ovary or peritoneum. Gynecol Oncol 2012; 125: 661-666 doi:10.1016/j.ygyno.2011.12.080
    CrossrefPubMedGoogle Scholar
  • 38 Farley J, Brady WE, Vathipadiekal V. et al. Selumetinib in women with recurrent low-grade serous carcinoma of the ovary or peritoneum: an open-label, single-arm, phase 2 study. Lancet Oncol 2013; 14: 134-140 doi:10.1016/S1470-2045(12)70572-7
    CrossrefPubMedGoogle Scholar