Liane Deligdisch
Mount Sinai Medical Center, USA
Title: Early Ovarian Carcinoma: Clinical-Pathological Correlations and Molecular Studies.
Biography
Biography: Liane Deligdisch
Abstract
Ovarian carcinoma (OC) is the most lethal gynecological tumor, most cases being diagnosed in late stages due to paucity of symptoms and absence of specific tumor markers in early stages of the disease. Preinvasive (dysplastic) lesions have been described in the ovaries by histologic, morphometric and immunohistologic methods, and in the fallopian tubes. Five year survival of OC is 30-35% in all stages and 80-90% in the rarely diagnosed stage I when the tumor is confined to the ovary(ies). Review of 99 cases of Stage I OC revealed a shift in the histologic distribution of early OC which are mostly non-Serous OC (NSOC) vs. the predominance of Serous OC (SOC) in all stages. The predominant early OC are endometrioid, mucinous and clear cell carcinomas. The rare Stage I SOC are detected randomly, most due to intense follow-up of high-risk patients (BRCA1/2 positivity, personal or family breast cancer). The clinical background of the patients is different in the NSOC patients who are younger, often hyperestrogenic and infertile, with coexisting endometriosis, endometrial polyps/hyperplasia/neoplasia, symptomatic lesions leading to an earlier diagnosis than the mostly asymptomatic SOC. Stage I OC is a heterogeneous group of tumors requiring different therapeutic approaches. Our recent molecular studies including markers, some of which targeting stem cells (HLA, Notch 3, Betacatenin, GLI-2, Cyclin E) offer an insight into early carcinogenesis of OC and may have an impact on therapeutic choices of this elusive and often deadly neoplasm.