The role of the fallopian tube in ovarian serous carcinogenesis: biologic mechanisms and clinical impacts

Epithelial ovarian tumors, especially serous carcinomas, are a topic of frequent study due to their high prevalence and devastating prognosis. Much of the recent advancements have centered on the newly characterized precursor lesions in the fallopian tube. Although high-grade and low-grade serous carcinomas have distinct molecular pathogenesis and cellular carcinogenetic pathways, a common precursor cell, the fallopian tube secretory cell, has been identified. The classification of serous cancers, cellular precursor lesions and carcinogenesis is discussed in detail in this review, focusing on the role of the fallopian tube in the development of neoplasia. The development of prophylactic measures is also described, with particular emphasis on ovary-sparing salpingectomies for the prevention of ovarian serous cancer. Studies on the topic of tubal contribution of ovarian serous cancer development were identified for this review by searching the English language literature in the PubMed database, including publications from our own group. This was followed by a review of bibliographies from articles found through the search. Commentary from authors on the topic and clinical impact is also provided.