Adenocarcinoma of ovary

Adenocarcinoma of the ovary is a malignant epithelial tumor arising from the surface epithelium or cortical inclusion cysts of the ovary. It is the most common histological type of ovarian cancer and encompasses several subtypes, including serous (high-grade and low-grade), endometrioid, clear cell, and mucinous adenocarcinomas. High-grade serous carcinoma is by far the most prevalent subtype, accounting for approximately 70% of epithelial ovarian cancers. The disease primarily affects the female reproductive system but frequently spreads within the peritoneal cavity, involving the omentum, bowel surfaces, and other abdominal organs. Distant metastases to the liver, lungs, and pleura can also occur. Symptoms are often vague and nonspecific in early stages, contributing to late diagnosis in the majority of patients. Common clinical features include abdominal bloating, pelvic or abdominal pain, difficulty eating or early satiety, urinary frequency or urgency, ascites, and unintentional weight loss. Many patients present at advanced stages (FIGO stage III or IV). Elevated serum CA-125 levels are frequently observed, particularly in serous subtypes, and are used as a biomarker for monitoring disease. Treatment typically involves a combination of cytoreductive (debulking) surgery and platinum-based chemotherapy, most commonly carboplatin combined with paclitaxel. In recent years, targeted therapies have significantly expanded the treatment landscape. PARP inhibitors (such as olaparib, niraparib, and rucaparib) have demonstrated particular benefit in patients with BRCA1/BRCA2 mutations or homologous recombination deficiency. Bevacizumab, an anti-angiogenic agent, is also used in combination with chemotherapy. Germline mutations in BRCA1 and BRCA2 genes account for approximately 15-20% of high-grade serous ovarian cancers, and genetic testing is recommended for all patients with epithelial ovarian cancer to guide treatment decisions and family risk assessment.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

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