Peritoneal dissemination of high-grade serous ovarian cancer: pivotal roles of chromosomal instability and epigenetic dynamics

Epithelial ovarian cancer remains the lethal gynecological malignancy in women. The representative histotype is high-grade serous carcinoma (HGSC), and most patients with HGSC present at advanced stages with peritoneal dissemination. Since the peritoneal dissemination is the most important factor for poor prognosis of the patients, complete exploration for its molecular mechanisms is mandatory. In this narrative review, being based on the clinical, pathologic, and genomic findings of HGSC, chromosomal instability and epigenetic dynamics have been discussed as the potential drivers for cancer development in the fallopian tube, acquisition of cancer stem cell (CSC)-like properties, and peritoneal metastasis of HGSC. The natural history of carcinogenesis with clonal evolution, and adaptation to microenvironment of peritoneal dissemination of HGSC should be targeted in the novel development of strategies for prevention, early detection, and precision treatment for patients with HGSC.

Automated summary

Epithelial ovarian cancer, particularly high-grade serous carcinoma (HGSC), is a deadly gynecological malignancy in women, often diagnosed at advanced stages with peritoneal dissemination. Chromosomal instability and epigenetic dynamics are believed to drive cancer development in the fallopian tube and peritoneal metastasis in HGSC, highlighting the importance of targeting clonal evolution and the peritoneal microenvironment in developing novel strategies for prevention and treatment.