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New Schema for Diagnosis of Ovarian Cancer Proposed

Proposal suggests classifying tumors based on clinical behavior and genetic features

FRIDAY, April 11 (HealthDay News) -- A new model of ovarian cancer that distinguishes between slow-growing and rapidly growing tumors may allow more targeted screening and a more rational treatment approach, according to a review article published in the American Journal of Obstetrics & Gynecology in April.

Robert J. Kurman, M.D., of Johns Hopkins Medical Institutions in Baltimore, and colleagues question the utility of the current model of ovarian cancer progression, which classifies tumors based on their confinement to the ovary (stage I) or spread to local or distant organs (stage II-IV), and propose a new model of ovarian carcinogenesis based on clinical, pathological and molecular genetic studies.

The authors propose a schema that classifies ovarian tumors as either low-grade, slower-growing cancers (type I), or high-grade, aggressive cancers (type II). The indolent type I tumors -- which include low-grade micropapillary serous carcinoma, and mucinous, endometrioid and clear cell carcinomas -- are characterized by genetic stability and are often diagnosed at early stages. Type II tumors, in contrast, which include high-grade serous carcinomas and undifferentiated tumors, are characterized by TP53 mutations and genetic instability, and quickly progress to advanced stages.

This proposed model "does not replace the histopathologic classification but by drawing attention to the molecular genetic events that play a role in tumor progression can shed light on new approaches to early detection and treatment," the authors conclude.

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