Serous tubal intraepithelial carcinomas associated with high-grade serous ovarian carcinomas: a systematic review

Abstract

Background: Serous tubal intraepithelial carcinomas (STICs) have been documented in high-grade serous ovarian carcinomas (HGSOCs). However, the rate of association between STICs and HGSOCs and, therefore, the fraction of HGSOCs that are likely to have originated from the fallopian tube (FT), has remained unclear. Objective: To appraise the literature describing the association between STICs and established HGSOCs. Search strategy: Ovid MEDLINE and EMBASE were searched. Selection criteria: Studies were included if they evaluated the frequency of STICs in HGSOCs, and were published in an English peer-reviewed journal. Data collection and analysis: Appropriate studies were evaluated for their compliance with the ‘Strengthening and Reporting of Observational Studies in Epidemiology (STROBE)’ criteria. Main results: Ten articles met the study selection criteria. The reported coexistence between STICs and HGSOCs ranged from 11% to 61% (mean: 31%, 95% CI: 17–46%). STICs were rarely found in other gynaecological cancers. Small sample size, lack of objective criteria to identify STICs and the retrospective nature of the studies contributed to the variability in reporting the rate of the association. Conclusions: STICs were identified commonly in the FTs of women with HGSOC. Finding the true rate of association between STICs and HGSOCs will require further investigations. While there is evidence that a fraction of HGSOCs arise from the FTs, an accurate estimate of that fraction remains to be determined. The lack of an accurate estimate of the association makes it difficult to evaluate the potential magnitude of reduction of HGSOCs following prophylactic salpingectomy. Tweetable abstract: A systematic review of the incidence of STICs in HGSOCs identifies significant methodological inconsistencies.