Serous ovarian, fallopian tube and primary peritoneal cancers: A common disease or separate entities — A systematic review

• Primary peritoneal cancer patients were older, had higher parity and poorer survival compared to primary ovarian cancer patients.
• Differences found between primary peritoneal cancer and primary ovarian cancer indicate different carcinogenic pathways.
• Only few differences between primary fallopian tube cancer and primary ovarian cancer have been found.

ObjectiveThe aim of this systematic review is to analyze data on risk factors, epidemiology, clinicopathology and molecular biology from studies comparing primary peritoneal cancer, fallopian tube cancer and ovarian cancer of serous histology, in order to achieve a greater understanding of whether or not these disorders should be considered as separate entities.MethodsA systematic literature search was conducted in PubMed and MEDLINE. Case–control studies comparing primary serous peritoneal or fallopian tube carcinomas with primary serous ovarian carcinomas or a control group were included.ResultsTwenty-eight studies were found eligible. Primary peritoneal cancer patients were older, had higher parity, were more often obese and had poorer survival compared to ovarian cancer patients. Differences in protein expression patterns of Her2/neu, estrogen and progestin receptors and frequency of loss of heterozygosity differed between primary peritoneal cancer and primary ovarian cancer patients. No major differences were found between primary fallopian tube cancer and primary ovarian cancer. The proportion of serous tubal intraepithelial carcinomas (STIC) was lower in primary peritoneal cancer and primary ovarian cancer compared to primary fallopian tube cancer.ConclusionExcept from differences in the proportion of STIC only few differences between primary fallopian tube cancer and primary ovarian cancer have been found. In contrast, observed differences in risk factor profile, clinicopathologic and prognostic factors, as well as in the molecular patterns, indicate that peritoneal cancer and ovarian cancer may be linked to different carcinogenic pathways.