Ovarian High-Grade Serous Carcinoma: Assessing Pathology for Site of Origin, Staging and Post-neoadjuvant Chemotherapy Changes

Surg Pathol Clin. 2019 Jun;12(2):515-528. doi: 10.1016/j.path.2019.01.007.

Abstract

High-grade serous (HGSC) stands apart from the other ovarian cancer histotypes in being the most frequent, in occurring as part of a genetic predisposition in a significant proportion of cases, and in having the poorest clinical outcomes. Although the pathologic diagnosis of HGSC is now made with high accuracy, there remain areas of disagreement regarding viewpoints on tissue site of origin and designation of primary site, with impact on staging in low-stage cases, as well as difficulties in reproducible and clinically relevant reporting of HGSC in specimens taken after neoadjuvant chemotherapy. These areas are discussed in the current article.

Keywords: High-grade serous carcinoma; Primary site; Serous tubal intraepithelial carcinoma; Staging; chemotherapy response score.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / therapeutic use
  • Chemotherapy, Adjuvant
  • Cystadenocarcinoma, Serous / diagnosis
  • Cystadenocarcinoma, Serous / drug therapy
  • Cystadenocarcinoma, Serous / pathology*
  • Fallopian Tubes / pathology
  • Female
  • Humans
  • Neoadjuvant Therapy
  • Neoplasm Grading
  • Neoplasm Staging
  • Ovarian Neoplasms / diagnosis
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / pathology*

Substances

  • Antineoplastic Agents