Recurrent low-grade carcinoma of the ovary less responsive to chemo than more common ovarian cancers

One area to explore further is hormonal therapy, a treatment that has been shown to have some activity against low-grade serous carcinoma, he said. A detailed analysis of the M.D. Anderson experience with hormonal therapy is planned in the near future.

Low-grade serous carcinoma represents about ten percent of all serous ovarian cancers. The disease is characterized by a young age at diagnosis - an average of 42 years old, versus more common ovarian cancers, which are generally diagnosed at about 60 years old. In addition, the median overall survival of women with low-grade serous carcinomas is much longer than that of patient with high-grade ovarian cancers-82+ months versus 50-67 months in various reported series.

Two-Tier Grading System Advances Better Treatment Options

Histologic grade has been shown to be one of the most important prognostic factors in ovarian serous carcinoma cases. However, no universal grading system exists. Over the last 15 years, researchers at M. D. Anderson have developed a two-tier grading system for serous carcinoma of the ovary (low and high), based on knowledge that this type of epithelial ovarian cancer comprises not one homogenous group of tumors but rather two distinct phenotypes.

Historically, a three-tier grading system to classify tumors has been used, but there has been no precise mechanism to define the thresholds between the grades, particularly grades two and three. Consequently, there were variations in designating how ovarian tumors should be classified and ultimately, treated.

Rare Ovarian Tumors Receive Increasing Attention

The study of rare cancers, such as low-grade serous carcinoma of the ovary, brings inherent challenges, including the limited number of cases to examine, difficulty in obtaining tissue samples, low funding, and the small pool of investigators working on research, according to Gershenson.

Recognizing the need for more research, the Gynecologic Oncology Group, a National Cancer Institute-funded cooperative group, recently established a rare tumor committee that has initiated a separate series of clinical trials for recurrent low-grade serous carcinoma as well as for other rare ovarian cancers.

Gershenson said that changing the design of clinical trials to segregate patients is key. "In addition to providing direct benefits to patients and their families, the study of rare tumors can also uncover information about the etiology, biology, and treatment of more common cancers."

In addition to Gershenson, authors on the study include: Charlotte Sun, Dr.P.H., Diane Bodurka, M.D., Robert Coleman, M.D., Karen Lu, M.D., Anil Sood, M.D., and John Kavanagh, M.D., all of M. D. Anderson's Department of Gynecologic Oncology.

About M. D. Anderson

The University of Texas M. D. Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. M. D. Anderson is one of only 39 Comprehensive Cancer Centers designated by the National Cancer Institute. For five of the past eight years, M. D. Anderson has ranked No. 1 in cancer care in "America's Best Hospitals," a survey published annually in U.S. News and World Report.