Progress in diagnosis and treatment of mucinous ovarian cancer

doi:10.19401/j.cnki.1007-3639.2024.01.006

Abstract

Abstract:

Mucinous ovarian cancer (MOC) is a rare pathological type different from epithelial ovarian cancer, and the clinical treatment should refer to serous ovarian cancer (SOC) guidelines. However, since the clinicopathological features of MOC are significantly different from SOC, careful differentiation is needed in diagnosis and treatment. Surgery combined with adjuvant chemotherapy is the standard treatment for MOC. However, due to the low prevalence rate, it is difficult to carry out clinical trials, hence lacking evidence-based medicine and consensus on the indications of intraoperative appendectomy and the choice of postoperative adjuvant chemotherapy. In addition, further translational preclinical studies of targeted therapy and immunotherapy are needed to facilitate the diagnosis and individualized treatment of MOC.

Key words: Ovarian cancer, Mucinous ovarian cancer, Progress in diagnosis and treatment

CLC Number:

R737.31

LI Tong, YANG Huijuan. Progress in diagnosis and treatment of mucinous ovarian cancer[J]. China Oncology, 2024, 34(1): 90-96.

References 56

[1]	MORICE P, GOUY S, LEARY A. Mucinous ovarian carcinoma[J]. N Engl J Med, 2019, 380(13): 1256-1266. doi: 10.1056/NEJMra1813254
[2]	GATES M A, ROSNER B A, HECHT J L, et al. Risk factors for epithelial ovarian cancer by histologic subtype[J]. Am J Epidemiol, 2010, 171(1): 45-53. doi: 10.1093/aje/kwp314 pmid: 19910378
[3]	KELEMEN L E, KÖBEL M. Mucinous carcinomas of the ovary and colorectum: different organ, same dilemma[J]. Lancet Oncol, 2011, 12(11): 1071-1080. doi: 10.1016/S1470-2045(11)70058-4 pmid: 21616717
[4]	WAGNER B J, BUCK J L, SEIDMAN J D, et al. From the archives of the AFIP. Ovarian epithelial neoplasms: radiologic-pathologic correlation[J]. Radiographics, 1994, 14(6): 1351-1374;quiz 1375-1376. pmid: 7855346
[5]	BABAIER A, GHATAGE P. Mucinous cancer of the ovary: overview and current status[J]. Diagnostics (Basel), 2020, 10(1): 52.
[6]	ANGLESIO M S, KOMMOSS S, TOLCHER M C, et al. Molecular characterization of mucinous ovarian tumours supports a stratified treatment approach with HER2 targeting in 19% of carcinomas[J]. J Pathol, 2013, 229(1): 111-120. doi: 10.1002/path.2013.229.issue-1
[7]	JORDAN S J, GREEN A C, WHITEMAN D C, et al. Risk factors for benign, borderline and invasive mucinous ovarian tumors: epidemiological evidence of a neoplastic continuum?[J]. Gynecol Oncol, 2007, 107(2): 223-230. pmid: 17662378
[8]	HESS V, A’HERN R, NASIRI N, et al. Mucinous epithelial ovarian cancer: a separate entity requiring specific treatment[J]. J Clin Oncol, 2004, 22(6): 1040-1044. doi: 10.1200/JCO.2004.08.078 pmid: 15020606
[9]	SIEGEL R, MILLER K, JEMAL A. Cancer statistics, 2019[J]. CA Cancer J Clin, 2019, 69(1): 7-34. doi: 10.3322/caac.v69.1
[10]	KAJIYAMA H, SUZUKI S, UTSUMI F, et al. Comparison of long-term oncologic outcomes between metastatic ovarian carcinoma originating from gastrointestinal organs and advanced mucinous ovarian carcinoma[J]. Int J Clin Oncol, 2019, 24(8): 950-956. doi: 10.1007/s10147-019-01438-6 pmid: 30941534
[11]	PERES L C, CUSHING-HAUGEN K L, KÖBEL M, et al. Invasive epithelial ovarian cancer survival by histotype and disease stage[J]. J Natl Cancer Inst, 2019, 111(1): 60-68. doi: 10.1093/jnci/djy071 pmid: 29718305
[12]	PERREN T J. Mucinous epithelial ovarian carcinoma[J]. Ann Oncol, 2016, 27(Suppl 1): i53-i57. doi: 10.1093/annonc/mdw087
[13]	ATRI M, ALABOUSI A, REINHOLD C, et al. ACR appropriateness criteria^® clinically suspected adnexal mass, No acute symptoms[J]. J Am Coll Radiol, 2019, 16(5S): S77-S93. doi: 10.1016/j.jacr.2019.02.011
[14]	MACKENZIE R, KOMMOSS S, WINTERHOFF B J, et al. Targeted deep sequencing of mucinous ovarian tumors reveals multiple overlapping RAS-pathway activating mutations in borderline and cancerous neoplasms[J]. BMC Cancer, 2015, 15: 415. doi: 10.1186/s12885-015-1421-8 pmid: 25986173
[15]	CHANG K L, LEE M Y, CHAO W R, et al. The status of HER2 amplification and KRAS mutations in mucinous ovarian carcinoma[J]. Hum Genomics, 2016, 10(1): 40. doi: 10.1186/s40246-016-0096-9
[16]	HERRINGTON C S. WHO classification of tumours female genital tumours[M/OL]. International Agency for Research on Cancer, 2020.[2023-10-23]. https://www.research.ed.ac.uk/en/publications/who-classification-of-tumours-female-genital-tumours.
[17]	PRAT J, D'ANGELO E, ESPINOSA I. Ovarian carcinomas: at least five different diseases with distinct histological features and molecular genetics[J]. Hum Pathol, 2018, 80: 11-27. doi: S0046-8177(18)30230-2 pmid: 29944973
[18]	HUNTER S M, GORRINGE K L, CHRISTIE M, et al. Pre-invasive ovarian mucinous tumors are characterized by CDKN2A and RAS pathway aberrations[J]. Clin Cancer Res, 2012, 18(19): 5267-5277. doi: 10.1158/1078-0432.CCR-12-1103 pmid: 22891197
[19]	SEIDMAN J D, KURMAN R J, RONNETT B M. Primary and metastatic mucinous adenocarcinomas in the ovaries: incidence in routine practice with a new approach to improve intraoperative diagnosis[J]. Am J Surg Pathol, 2003, 27(7): 985-993. doi: 10.1097/00000478-200307000-00014 pmid: 12826891
[20]	DUNDR P, BÁRTŮ M, BOSSE T, et al. Primary mucinous tumors of the ovary: an interobserver reproducibility and detailed molecular study reveals significant overlap between diagnostic categories[J]. Mod Pathol, 2023, 36(1): 100040. doi: 10.1016/j.modpat.2022.100040
[21]	NOLEN B, MARRANGONI A, VELIKOKHATNAYA L, et al. A serum based analysis of ovarian epithelial tumorigenesis[J]. Gynecol Oncol, 2009, 112(1): 47-54. doi: 10.1016/j.ygyno.2008.09.043 pmid: 19007974
[22]	AMIN M B, EDGE S B, GREENE F L, et al. AJCC cancer staging manual. 8th ed[M]. New York: Springer, 2017: 739-747.
[23]	VAN BAAL J, VAN DE VIJVER K K, COFFELT S B, et al. Incidence of lymph node metastases in clinical early-stage mucinous and seromucinous ovarian carcinoma: a retrospective cohort study[J]. BJOG, 2017, 124(3): 486-494. doi: 10.1111/bjo.2017.124.issue-3
[24]	MATSUO K, MACHIDA H, MARIANI A, et al. Adequate pelvic lymphadenectomy and survival of women with early-stage epithelial ovarian cancer[J]. J Gynecol Oncol, 2018, 29(5): e69. doi: 10.3802/jgo.2018.29.e69
[25]	HOOGENDAM J P, VLEK C A, WITTEVEEN P O, et al. Surgical lymph node assessment in mucinous ovarian carcinoma staging: a systematic review and meta-analysis[J]. BJOG, 2017, 124(3): 370-378. doi: 10.1111/bjo.2017.124.issue-3
[26]	GOUY S, SAIDANI M, MAULARD A, et al. Staging surgery in early-stage ovarian mucinous tumors according to expansile and infiltrative types[J]. Gynecol Oncol Rep, 2017, 22: 21-25.
[27]	ARMSTRONG D K, ALVAREZ R D, BAKKUM-GAMEZ J N, et al. Ovarian cancer, version 2.2020, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2021, 19(2): 191-226. doi: 10.6004/jnccn.2021.0007
[28]	CONLEY A B, FOURNIER K F, SOOD A K, et al. Secondary cytoreductive surgery with hyperthermic intraperitoneal chemotherapy for advanced or recurrent mucinous ovarian cancer[J]. Obstet Gynecol, 2023, 141(5): 1019-1023. doi: 10.1097/AOG.0000000000005154 pmid: 37023452
[29]	FIRAT CUYLAN Z, KARABUK E, OZ M, et al. Comparison of stage Ⅲ mucinous and serous ovarian cancer: a case-control study[J]. J Ovarian Res, 2018, 11(1): 91. doi: 10.1186/s13048-018-0464-2
[30]	MELAMED A, MANNING-GEIST B, BREGAR A J, et al. Associations between residual disease and survival in epithelial ovarian cancer by histologic type[J]. Gynecol Oncol, 2017, 147(2): 250-256. doi: S0090-8258(17)31225-8 pmid: 28822556
[31]	YOSHIHARA M, KAJIYAMA H, TAMAUCHI S, et al. Impact of uterus-preserving surgery on stage Ⅰ primary mucinous epithelial ovarian carcinoma: a multi-institutional study with propensity score-weighted analysis[J]. Int J Gynaecol Obstet, 2020, 150(2): 177-183. doi: 10.1002/ijgo.v150.2
[32]	BENTIVEGNA E, FRUSCIO R, ROUSSIN S, et al. Long-term follow-up of patients with an isolated ovarian recurrence after conservative treatment of epithelial ovarian cancer: review of the results of an international multicenter study comprising 545 patients[J]. Fertil Steril, 2015, 104(5): 1319-1324. doi: 10.1016/j.fertnstert.2015.06.008 pmid: 26149354
[33]	LEE J Y, JO Y R, KIM T H, et al. Safety of fertility-sparing surgery in primary mucinous carcinoma of the ovary[J]. Cancer Res Treat, 2015, 47(2): 290-297. doi: 10.4143/crt.2014.004
[34]	KAJIYAMA H, SHIBATA K, MIZUNO M, et al. Fertility-sparing surgery in young women with mucinous adenocarcinoma of the ovary[J]. Gynecol Oncol, 2011, 122(2): 334-338. doi: 10.1016/j.ygyno.2011.04.016 pmid: 21575985
[35]	ROSENDAHL M, HAUEBERG OESTER L A, HØGDALL C K. The importance of appendectomy in surgery for mucinous adenocarcinoma of the ovary[J]. Int J Gynecol Cancer, 2017, 27(3): 430-436. doi: 10.1097/IGC.0000000000000910 pmid: 28060142
[36]	LIN J E, SEO S, KUSHNER D M, et al. The role of appendectomy for mucinous ovarian neoplasms[J]. Am J Obstet Gynecol, 2013, 208(1): 46. e1-46.e4.
[37]	BAMIAS A, SOTIROPOULOU M, ZAGOURI F, et al. Prognostic evaluation of tumour type and other histopathological characteristics in advanced epithelial ovarian cancer, treated with surgery and paclitaxel/carboplatin chemotherapy: cell type is the most useful prognostic factor[J]. Eur J Cancer, 2012, 48(10): 1476-1483. doi: 10.1016/j.ejca.2011.09.023 pmid: 22047635
[38]	TRIMBOS J B, PARMAR M, VERGOTE I, et al. International collaborative ovarian neoplasm trial 1 and adjuvant chemotherapy in ovarian neoplasm trial: two parallel randomized phase Ⅲ trials of adjuvant chemotherapy in patients with early-stage ovarian carcinoma[J]. J Natl Cancer Inst, 2003, 95(2): 105-112. doi: 10.1093/jnci/95.2.105
[39]	LEDERMANN J A, LUVERO D, SHAFER A, et al. Gynecologic Cancer InterGroup (GCIG) consensus review for mucinous ovarian carcinoma[J]. Int J Gynecol Cancer, 2014, 24(9 Suppl 3): S14-S19. doi: 10.1097/IGC.0000000000000296
[40]	NASIOUDIS D, HAGGERTY A F, GIUNTOLI R L Ⅱ, et al. Adjuvant chemotherapy is not associated with a survival benefit for patients with early stage mucinous ovarian carcinoma[J]. Gynecol Oncol, 2019, 154(2): 302-307. doi: S0090-8258(19)31233-8 pmid: 31155308
[41]	KURNIT K C, SINNO A K, FELLMAN B M, et al. Effects of gastrointestinal-type chemotherapy in women with ovarian mucinous carcinoma[J]. Obstet Gynecol, 2019, 134(6): 1253-1259. doi: 10.1097/AOG.0000000000003579 pmid: 31764736
[42]	VAN DRIEL W J, KOOLE S N, SIKORSKA K, et al. Hyperthermic intraperitoneal chemotherapy in ovarian cancer[J]. N Engl J Med, 2018, 378(3): 230-240. doi: 10.1056/NEJMoa1708618
[43]	MERCIER F, BAKRIN N, BARTLETT D L, et al. Peritoneal carcinomatosis of rare ovarian origin treated by cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a multi-institutional cohort from PSOGI and BIG-RENAPE[J]. Ann Surg Oncol, 2018, 25(6): 1668-1675. doi: 10.1245/s10434-018-6464-z pmid: 29637438
[44]	张德普, 孙阳, 张师前, 等. 黏液性卵巢癌诊断与治疗中国专家共识(2021年版)[J]. 中国微创外科杂志, 2021, 21(7): 577-588.
	ZHANG D P, SUN Y, ZHANG S Q, et al. Chinese expert consensus on the diagnosis and treatment of mucinous ovarian cancer (2021 edition)[J]. Chin J Minim Inva Surg, 2021, 21(7): 577-588.
[45]	GORRINGE K L, CHEASLEY D, WAKEFIELD M J, et al. Therapeutic options for mucinous ovarian carcinoma[J]. Gynecol Oncol, 2020, 156(3): 552-560. doi: S0090-8258(19)31836-0 pmid: 31902686
[46]	RICCI F, GUFFANTI F, AFFATATO R, et al. Establishment of patient-derived tumor xenograft models of mucinous ovarian cancer[J]. Am J Cancer Res, 2020, 10(2): 572-580. pmid: 32195028
[47]	WU Y S, SHUI L, SHEN D, et al. Bevacizumab combined with chemotherapy for ovarian cancer: an updated systematic review and meta-analysis of randomized controlled trials[J]. Oncotarget, 2017, 8(6): 10703-10713. doi: 10.18632/oncotarget.12926 pmid: 27793044
[48]	MCALPINE J N, WIEGAND K C, VANG R, et al. HER2 overexpression and amplification is present in a subset of ovarian mucinous carcinomas and can be targeted with trastuzumab therapy[J]. BMC Cancer, 2009, 9: 433. doi: 10.1186/1471-2407-9-433 pmid: 20003286
[49]	VAN CUTSEM E, KÖHNE C H, HITRE E, et al. Cetuximab and chemotherapy as initial treatment for metastatic colorectal cancer[J]. N Engl J Med, 2009, 360(14): 1408-1417. doi: 10.1056/NEJMoa0805019
[50]	SATO N, SAGA Y, MIZUKAMI H, et al. Cetuximab inhibits the growth of mucinous ovarian carcinoma tumor cells lacking KRAS gene mutations[J]. Oncol Rep, 2012, 27(5): 1336-1340.
[51]	INABA K, ODA K, AOKI K, et al. Synergistic antitumor effects of combination PI3K/mTOR and MEK inhibition (SAR245409 and pimasertib) in mucinous ovarian carcinoma cells by fluorescence resonance energy transfer imaging[J]. Oncotarget, 2016, 7(20): 29577-29591. doi: 10.18632/oncotarget.8807 pmid: 27102436
[52]	SEGEV Y, PAL T, ROSEN B, et al. Risk factors for ovarian cancers with and without microsatellite instability[J]. Int J Gynecol Cancer, 2014, 24(4): 664-669. doi: 10.1097/IGC.0000000000000134 pmid: 24755492
[53]	PAL T, PERMUTH-WEY J, KUMAR A, et al. Systematic review and meta-analysis of ovarian cancers: estimation of microsatellite-high frequency and characterization of mismatch repair deficient tumor histology[J]. Clin Cancer Res, 2008, 14(21): 6847-6854. doi: 10.1158/1078-0432.CCR-08-1387 pmid: 18980979
[54]	MURPHY M A, WENTZENSEN N. Frequency of mismatch repair deficiency in ovarian cancer: a systematic review This article is a US Government work and, as such, is in the public domain of the United States of America[J]. Int J Cancer, 2011, 129(8): 1914-1922. doi: 10.1002/ijc.25835 pmid: 21140452
[55]	DIAZ L A, MARABELLE A, DELORD J P, et al. Pembrolizumab therapy for microsatellite instability high (MSI-H) colorectal cancer (CRC) and non-CRC[J]. J Clin Oncol, 2017, 35(15_suppl): 3071. doi: 10.1200/JCO.2017.35.15_suppl.3071
[56]	MEAGHER N S, HAMILTON P, MILNE K, et al. Profiling the immune landscape in mucinous ovarian carcinoma[J]. Gynecol Oncol, 2023, 168: 23-31. doi: 10.1016/j.ygyno.2022.10.022