Abstract
Introduction
Molecular pathological research has contributed to improving the knowledge of different subtypes of ovarian cancer. In parallel with the implementation of the new FIGO staging classification, the WHO classification was revised. The latter is mainly based on the histopathological findings and defines the actual type of tumor. It has, therefore, also an important impact on prognosis and therapy of the patient.
Materials and methods
The new WHO Classification of Ovarian Cancer published 2014 by Robert Kurman and co-authors is summarized. The major changes compared to the hitherto existing classification are presented.
Results
The new classification eliminates the previous focus of mesothelial origin of ovarian cancer. Instead, it features a discussion of tubal carcinogenesis of hereditary and some other high-grade serous carcinomas. The previously assumed pathogenesis pathway may be correct for some, but not for all, serous cancers. The new classification was established to classify ovarian cancer in a more consistent way. The earlier transitional cell type of ovarian cancer has been removed while seromucinous tumors have been added as a new entity. The role of some borderline tumors as one possible step in the progression from benign to invasive lesions is incorporated. The article summarizes the essential updates concerning serous, mucinous, seromucinous, endometrioid, clear-cell, and Brenner tumors.
Conclusion
The new WHO classification takes into account the recent findings on the origin, pathogenesis, and prognosis of different ovarian cancer subtypes. The tubal origin of hereditary and some non-hereditary high-grade serous cancers is mentioned in contrast to the hitherto theory of mesothelial origin of tumors. Seromucinous tumors represent a new entity.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Meinhold-Heerlein I, Hauptmann S (2014) The heterogeneity of ovarian cancer. Arch Gynecol Obstet 289:237–239
Prat J, Oncology FCoG (2014) Staging classification for cancer of the ovary, fallopian tube, and peritoneum. Int J Gynaecol Obstet Off Int Feder Gynaecol Obstet 124:1–5
Zeppernick F, Meinhold-Heerlein I (2014) The new FIGO staging system for ovarian, fallopian tube, and primary peritoneal cancer. Arch Gynecol Obstet 290:839–842
Meinhold-Heerlein I, Fotopoulou C, Harter P et al (2015) Statement by the Kommission Ovar of the AGO: the new FIGO and WHO classifications of ovarian, fallopian tube and primary peritoneal cancer. Geburtshilfe Frauenheilkd 75:1021–1027
Kurman RJ, Carcangiu ML, Herrington CS et al (2014) WHO Classification of Tumours of Female Reproductive Organs. In WHO Classification of Tumours. 4. Aufl. Lyon: WHO Press
Pecorelli S, Benedet JL, Creasman WT et al (1999) FIGO staging of gynecologic cancer. 1994–1997 FIGO Committee on Gynecologic Oncology. International Federation of Gynecology and Obstetrics. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 65:243–249
Pecorelli S, Benedet JL, Creasman WT et al (1999) FIGO staging of gynecologic cancer. 1994–1997 FIGO Committee on Gynecologic Oncology. International Federation of Gynecology and Obstetrics. International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 64:5–10
Shepherd JH (1989) Revised FIGO staging for gynaecological cancer. Br J Obstet Gynaecol 96:889–892
Ledermann JA, Raja FA, Fotopoulou C et al (2013) Newly diagnosed and relapsed epithelial ovarian carcinoma: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of oncology : official journal of the European Society for Medical Oncology/ESMO 24 Suppl 6:vi24–32
Wagner U, Harter P, Hilpert F et al (2013) S3-guideline on diagnostics, therapy and follow-up of malignant ovarian tumours: short version 1.0—AWMF registration number: 032/035OL, June 2013. Geburtshilfe Frauenheilkd 73:874–889
Cancer NCCf (2011) Ovarian cancer: the recognition and initial management of ovarian cancer. In: http://www.nice.org.uk: National Collaborating Centre for Cancer, Cardiff, Wales
Shih Ie M, Kurman RJ (2004) Ovarian tumorigenesis: a proposed model based on morphological and molecular genetic analysis. The American journal of pathology 164:1511–1518
Przybycin CG, Kurman RJ, Ronnett BM et al (2010) Are all pelvic (nonuterine) serous carcinomas of tubal origin? Am J Surg Pathol 34:1407–1416
Kurman RJ, Shih Ie M (2011) Molecular pathogenesis and extraovarian origin of epithelial ovarian cancer—shifting the paradigm. Hum Pathol 42:918–931
Meinhold-Heerlein I, Bauerschlag D, Hilpert F et al (2005) Molecular and prognostic distinction between serous ovarian carcinomas of varying grade and malignant potential. Oncogene 24:1053–1065
Hauptmann S, du Bois A, Meinhold-Herlein I et al (2014) Histological grading of epithelial ovarian cancer. Review and recommendation. Der Pathologe 35:497–503
Prat J (2012) New insights into ovarian cancer pathology. Ann Oncol Off J Eur Soc Med Oncol ESMO 23(Suppl 10):x111–x117
Hauptmann S (2015) Die neue WHO-Klassifikation des Ovarial-. Tuben- und primären Peritonealkarzinoms
Chene G, Ouellet V, Rahimi K et al (2015) The ARID1A pathway in ovarian clear cell and endometrioid carcinoma, contiguous endometriosis, and benign endometriosis. Int J Gynaecol Obstet Off Organ Int Feder Gynaecol Obstet 130:27–30
Wiegand KC, Shah SP, Al-Agha OM et al (2010) ARID1A mutations in endometriosis-associated ovarian carcinomas. New Engl J Med 363:1532–1543
du Bois A, Ewald-Riegler N, de Gregorio N et al (2013) Borderline tumours of the ovary: a cohort study of the Arbeitsgmeinschaft Gynakologische Onkologie (AGO) Study Group. Eur J Cancer 49:1905–1914
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
This article does not contain any studies with human participants or animals performed by any of the authors.
Conflict of interest
The authors declare that they have no conflict of interest.
Additional information
On behalf of the Kommission Ovar of AGO.
Rights and permissions
About this article
Cite this article
Meinhold-Heerlein, I., Fotopoulou, C., Harter, P. et al. The new WHO classification of ovarian, fallopian tube, and primary peritoneal cancer and its clinical implications. Arch Gynecol Obstet 293, 695–700 (2016). https://doi.org/10.1007/s00404-016-4035-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-016-4035-8