Endometriosis and ovarian cancer: a review.
OBJECTIVE
To describe the relationship between endometriosis and ovarian cancer.


METHODS
Review of the relevant clinical, epidemiologic, and molecular biology literature.


METHODS
Studies published in the English language using the MEDLINE database.


METHODS
Relevant studies were reviewed by the three authors and those that seem to be of significant scientific value, based on the methodology and statistical power, were included.


RESULTS
Endometriosis and ovarian cancer share many common predisposing factors. Both conditions demonstrate similar patterns regarding local invasion and distal spread they respond similarly to estrogen-induced growth signaling, they express resistance to apoptotic mechanisms and they are characterized by genomic instability. Endometrioid and clear-cell are the most frequent types of ovarian cancer associated with endometriosis. Tubal ligation, in women with endometriosis, seems to prevent retrograde menstruation but it has also been shown to be protective from these types of ovarian cancer.


CONCLUSIONS
There is evidence to support that endometriosis (by definition a benign process), could simultaneously have the potential for malignant transformation. More studies are needed to establish risk factors that may lead to malignant transformation of this condition and to identify predisposed individuals who may require closer surveillance.
Vlahos
Nikos F
NF
Division of Reproductive Endocrinology, Department of Gynecology and Obstetrics, The Johns Hopkins Medical Institutions, Baltimore, Maryland, USA. nvlahos@jhmi.edu
Kalampokas
Theodoros
T
Fotiou
Stylianos
S
D018262:Adenocarcinoma, Clear Cell / Q000453:epidemiology / Q000235:genetics / Q000276:immunology; D004715:Endometriosis / Q000453:epidemiology / Q000235:genetics / Q000276:immunology; D005260:Female; D006801:Humans; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000235:genetics / Q000276:immunology