title: The duplicitous origin of ovarian cancer.
abstract: The past few decades have seen many advances in the treatment of a variety of cancers. Unfortunately, for ovarian cancer, which is the most lethal type of gynecologic malignancy, no new therapeutic approach has been successfully introduced since the 1990s. Ovarian cancer is usually detected in later stages, when remission rates are high and tumors are resistant to chemotherapy. Little is known about the primary lesion in ovarian cancer. Recently, it has been shown that the origin of ovarian cancer can be cells from adjacent tissue or cells from other primary tumors, which make their way to the ovaries due to the unique nature of their microenvironment during ovulation. The tumor in ovarian cancer is heterogeneous and hierarchically organized. In this review, we discuss the role of ovarian cancer stem cells in the process of tumor formation and recurrence. We propose the need to shift the paradigm away from the classification of ovarian cancer as a single disease with a single cellular origin. Understanding the complexity of the disease will facilitate devising new methods for fighting this cancer and improving the life of many women inflicted with the disease.
authors.affiliation: Department of Obstetrics Gynecology and Reproductive Sciences, Reproductive Immunology Unit, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Gil
authors.initials: G
authors.lastname: Mor
authors.forename: Ayesha
authors.initials: A
authors.lastname: Alvero
keywords: Ovarian cancer; cancer markers; cancer stem cells; chemotherapy
references.citation: Am J Surg Pathol. 2003 Mar;27(3):281-92
references.pmid: 12604884
references.citation: Biol Reprod. 1980 Feb;22(1):73-106
references.pmid: 6991013
references.citation: Cancer Biol Ther. 2011 Apr 15;11(8):708-13
references.pmid: 21317559
references.citation: J Oncol. 2011;2011:620523
references.pmid: 21904548
references.citation: Ultrastruct Pathol. 2009 Jul-Aug;33(4):175-81
references.pmid: 19728235
references.citation: CA Cancer J Clin. 2009 Jul-Aug;59(4):225-49
references.pmid: 19474385
references.citation: Stem Cells. 2009 Dec;27(12):2875-83
references.pmid: 19816957
references.citation: Am J Surg Pathol. 2010 Mar;34(3):433-43
references.pmid: 20154587
references.citation: Am J Reprod Immunol. 2011 Apr;65(4):438-47
references.pmid: 20825380
references.citation: Cancer. 1994 Apr 1;73(7):1859-64
references.pmid: 8137211
references.citation: Cancer Res. 2008 Jul 15;68(14):5658-68
references.pmid: 18632618
references.citation: Cancer Res. 2005 Apr 15;65(8):3025-9
references.pmid: 15833827
references.citation: Front Biosci (Landmark Ed). 2011 Jan 01;16:368-92
references.pmid: 21196176
references.citation: Clin Cancer Res. 2008 Feb 15;14(4):1065-72
references.pmid: 18258665
references.citation: Cell Cycle. 2009 Jan 1;8(1):158-66
references.pmid: 19158483
references.citation: J Biol Chem. 2012 Apr 20;287(17):13840-9
references.pmid: 22396544
references.citation: Int J Womens Health. 2010 Nov 19;2:411-27
references.pmid: 21270965
references.citation: Am J Reprod Immunol. 2012 Mar;67(3):256-65
references.pmid: 21917055
references.citation: Stem Cells. 2009 Oct;27(10):2405-13
references.pmid: 19658191
references.citation: Proc Natl Acad Sci U S A. 2006 Jul 25;103(30):11154-9
references.pmid: 16849428
references.citation: Am J Obstet Gynecol. 2010 Dec;203(6):584.e1-22
references.pmid: 20965493
references.citation: Cancer Res. 2008 Jun 1;68(11):4311-20
references.pmid: 18519691
references.citation: Lancet Oncol. 2011 Oct;12(11):1071-80
references.pmid: 21616717
references.citation: Gynecol Oncol. 2005 Apr;97(1):155-65
references.pmid: 15790452
references.citation: Clin Lab Med. 2009 Mar;29(1):47-55
references.pmid: 19389550
references.citation: Virchows Arch. 2010 Jan;456(1):1-12
references.pmid: 19859732
references.citation: Exp Cell Res. 2011 Mar 10;317(5):575-89
references.pmid: 21223965