Abstract
Among American women, the most common cause of death from gynecologic malignancy is ovarian cancer. With the discovery and publicizing of hereditary cancer gene mutations, patients are actively seeking their physician’s advice on how to manage risk. As a cancer prevention measure, risk-reducing surgery has become a popular procedure. Based on studies of salpingo-oophorectomies from BRCA-positive women, the fallopian tube has been put forth as the cause of high-grade ovarian cancer. More recently, ovarian surface hilar stem cells have been suggested as the putative cells of origin. In this exciting time of new thinking about its origins, we stand on the threshold of new and promising strategies for more precise management of ovarian cancer patients.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilizeed in the production of this manuscript.
Key issues
• Ovarian cancer remains the number one killer of American women with gynecologic malignancy.
• Origin of high-grade ovarian carcinomas remains controversial.
• An origin of ovarian cancer from fallopian tube epithelium has been proposed.
• An origin of ovarian cancer from transformed ovarian hilar stem cells has been proposed.
• Most patients with high-stage ovarian cancer show good initial treatment response but, eventually develop chemoresistance and tumor recurrence.
• Ovarian cancers utilize a variety of strategies to acquire drug resistance.
• Novel new approaches using individualized and targeted treatments to bypass and/or overcome cancer cell chemoresistance, and induce stem cell differentiation, hold promise for ovarian cancer patients.