Resumen

ANTECEDENTES: El cáncer de ovario es una importante causa de muerte de mujeres, responsable de 150,000 fallecimientos anuales en el mundo, con una supervivencia a 5 años inferior a 45%. 

OBJETIVO: Exponer los avances en diagnóstico y tratamiento de la carcinogénesis de los tumores serosos ováricos y las repercusiones de los nuevos conceptos en el tratamiento clínico y quirúrgico.

METODOLOGÍA: Estudio retrospectivo basado en la búsqueda sistemática de artículos con las palabras clave (MeSH): neoplasmas serosos de ovario, carcinogénesis, carcinoma seroso de bajo grado y carcinoma seroso de alto grado. La selección de los artículos estuvo a cargo, de forma independiente, de dos investigadores. De la misma forma dos patólogos evaluaron los artículos preseleccionados.

RESULTADOS: Se seleccionaron y analizaron 66 artículos.

CONCLUSIONES: Para la creación y adopción de estrategias en prevención primaria, diagnóstico  y tratamiento de esta patología se requiere mayor comprensión de la fisiopatología y de los hallazgos encontrados en la última década, sobre todo los relacionados con las mutaciones en el gen BRCA, antecedentes familiares de tumores serosos del ovario, cáncer de mama o peritoneal de tipo epitelial, entre otras. La atención multidisciplinaria y actualizada repercutirá, significativamente, en la supervivencia de las pacientes.

PALABRAS CLAVE: Cáncer de ovario; causas oncológicas de muerte; carcinomas serosos intraepiteliales; predisposición genética; carcinogénesis; tumores ováricos serosos; mutaciones, cáncer peritoneal.

Abstract

BACKGROUND: Globally, ovarian cancer is the seventh neoplasm and the eight oncologic cause of death in women, responsible of 150,000 deaths per year, with a 5 year survival under the 45%, mainly represented by high-grade serous carcinomas. Findings such as serous intraepithelial carcinomas and genetic predisposition have become a constant for the vast majority of cases.

OBJECTIVE: To summarize and review the most recent advances about the carcinogenesis of the ovarian serous tumors, its implications on the pathological diagnosis and the consequences of these new concepts for the clinical and surgical therapies.

MATERIALS AND METHODS: We performed a systematic search to select all kinds of languages articles, using the keywords “serous ovarian neoplasms” AND “carcinogenesis” AND “low-grade serous carcinoma” OR “high-grade serous carcinoma”. Two investigators independently extracted characteristics and results to select the articles. Two pathologists independently did the assessment of the preselected articles selecting the most appropriate ones, based on their utility for this review.

RESULTS: 66 articles were selected and included in the bibliography for this review.

CONCLUSIONS: A better understanding of the physiopathology and many other new findings that have been done during the last decade are essential for the treatment of this patients, for the creation and application of strategies for primary prevention and screening for the risk, and the medical and surgical interventions, mainly directed to patients with mutations on BRCA, family history of breast, ovarian or peritoneal cancer, among other conditions. A multidisciplinary and updated approach will affect significantly the long-term survival.

KEYWORDS: Ovarian cancer; Cause of death; Serous intraepithelial carcinomas; Genetic predisposition; Carcinogenesis; Ovarian Serous tumors; Mutations; Peritoneal cancer.