Primary peritoneal carcinoma

Primary peritoneal carcinoma
Other names: Peritoneal serous carcinoma- high grade[1]
Peritoneum (blue)

Primary peritoneal cancer, also known as high-grade serous carcinoma of the peritoneum, is a cancer in the peritoneum which does not include disease in the ovaries or fallopian tubes.[1]

Most originate from precursor lesions in the fallopian tubes.[1] Distinguishing primary peritoneal cancer from cancer of the fallopian tube and ovarian cancer may be difficult but may not matter, as all behave similarly and the treatment is the same.[1]

Genetic causes

Although the precise causes are not known, a link with certain variants of BRCA1/2 has been described.[2] Furthermore, women with BRCA1/2 mutation have a 5% risk of developing primary peritoneal cancer even after prophylactic oophorectomy.

Primary peritoneal carcinoma shows similar rates of tumor suppressor gene dysfunction (p53, BRCA, WT1) as ovarian cancer and can also show an increased expression of HER-2/neu.

An association with vascular endothelial growth factor has been observed.[3]

Prognosis

Prognosis and treatment is the same as for the most common type of ovarian cancer, which is epithelial ovarian cancer.[4][5]

The median survival of primary peritoneal carcinomas is usually shorter by 2–6 months time when compared with serous ovarian cancer. Studies show median survival varies between 11.3 and 17.8 months. One study reported 19–40 month median survival (95% CI) with a five-year survival of 26.5%.

Elevated albumin levels have been associated with a more favorable prognosis.[6]

History

It was historically classified under "carcinoma of unknown primary" (CUP).[7]

References

  1. 1 2 3 4 WHO Classification of Tumours Editorial Board, ed. (2020). "3. Tumours of the peritoneum: High grade serous carcinoma of the peritoneum". Female genital tumours: WHO Classification of Tumours. Vol. 4 (5th ed.). Lyon (France): International Agency for Research on Cancer. p. 187. ISBN 978-92-832-4504-9. Archived from the original on 2022-06-17. Retrieved 2022-07-30.
  2. ↑ "Gynecologic Cancer Treatment—Primary Peritoneal Cancer—Dana-Farber Cancer Institute". Archived from the original on 2008-04-29. Retrieved 2008-05-07.
  3. ↑ Burger, Robert A.; Sill, Michael W.; Monk, Bradley J.; Greer, Benjamin E.; Sorosky, Joel I. (20 November 2007). "Phase II Trial of Bevacizumab in Persistent or Recurrent Epithelial Ovarian Cancer or Primary Peritoneal Cancer: A Gynecologic Oncology Group Study". Journal of Clinical Oncology. 25 (33): 5165–5171. doi:10.1200/JCO.2007.11.5345. PMID 18024863.
  4. ↑ "New Drug Combination for Ovarian and Primary Peritoneal Cancers - National Cancer Institute". Archived from the original on 2010-12-24. Retrieved 2008-05-07.
  5. ↑ Peritoneal Cancer at eMedicine
  6. ↑ Alphs HH, Zahurak ML, Bristow RE, Díaz-Montes TP (December 2006). "Predictors of surgical outcome and survival among elderly women diagnosed with ovarian and primary peritoneal cancer". Gynecol. Oncol. 103 (3): 1048–53. doi:10.1016/j.ygyno.2006.06.019. PMID 16876237.
  7. ↑ Jaaback KS, Ludeman L, Clayton NL, Hirschowitz L (2006). "Primary peritoneal carcinoma in a UK cancer center: comparison with advanced ovarian carcinoma over a 5-year period". Int. J. Gynecol. Cancer. 16 Suppl 1: 123–8. doi:10.1111/j.1525-1438.2006.00474.x. PMID 16515579. S2CID 2907689.
Classification
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