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The Dualistic Model of Ovarian Carcinogenesis: Revisited, Revised, and Expanded

Published on Apr 1, 2016in American Journal of Pathology3.76
· DOI :10.1016/j.ajpath.2015.11.011
Robert J. Kurman107
Estimated H-index: 107
(Johns Hopkins University),
IeM Shih76
Estimated H-index: 76
(Johns Hopkins University)
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Abstract
Since our proposal of a dualistic model of epithelial ovarian carcinogenesis more than a decade ago, a large number of molecular and histopathologic studies were published that have provided important insights into the origin and molecular pathogenesis of this disease. This has required that the original model be revised and expanded to incorporate these findings. The new model divides type I tumors into three groups: i) endometriosis-related tumors that include endometrioid, clear cell, and seromucinous carcinomas; ii) low-grade serous carcinomas; and iii) mucinous carcinomas and malignant Brenner tumors. As in the previous model, type II tumors are composed, for the most part, of high-grade serous carcinomas that can be further subdivided into morphologic and molecular subtypes. Type I tumors develop from benign extraovarian lesions that implant on the ovary and which can subsequently undergo malignant transformation, whereas many type II carcinomas develop from intraepithelial carcinomas in the fallopian tube and, as a result, disseminate as carcinomas that involve the ovary and extraovarian sites, which probably accounts for their clinically aggressive behavior. The new molecular genetic data, especially those derived from next-generation sequencing, further underline the heterogeneity of ovarian cancer and identify actionable mutations. The dualistic model highlights these differences between type I and type II tumors which, it can be argued, describe entirely different groups of diseases.
  • References (104)
  • Citations (192)
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References104
Newest
#1Ian Jacobs (University of Manchester)H-Index: 65
#2Usha Menon (UCL: University College London)H-Index: 46
Last.Derek Cruickshank (James Cook University Hospital)H-Index: 12
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#1Yihong Wang (ZJU: Zhejiang University)H-Index: 5
#2Ren-Chin Wu (Johns Hopkins University)H-Index: 16
Last.Robert J. Kurman (Johns Hopkins University)H-Index: 107
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#1Emily Adler (SC: University of Southern California)H-Index: 2
#2Paulette Mhawech-Fauceglia (SC: University of Southern California)H-Index: 12
Last.Kate Lawrenson (SC: University of Southern California)H-Index: 20
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#1Jianfeng Shen (University of Texas MD Anderson Cancer Center)H-Index: 5
#2Yang Peng (University of Texas MD Anderson Cancer Center)H-Index: 6
Last.Ie Ming Shih (Johns Hopkins University)H-Index: 1
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#2Marek Grabiec (UMK: Nicolaus Copernicus University in Toruń)H-Index: 10
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#1Michael R. Wilson (MSU: Michigan State University)
#2Jake Reske (MSU: Michigan State University)H-Index: 1
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#1Weiwei Gong (TUM: Technische Universität München)
#2Yueyang Liu (TUM: Technische Universität München)H-Index: 1
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#1Annika Idahl (Umeå University)H-Index: 21
#2Anna Darelius (University of Gothenburg)
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#1Elizabeth A. Sadowski (UW: University of Wisconsin-Madison)H-Index: 17
#2Andrea Rockall (Imperial College London)H-Index: 11
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