The Lack of Progress in Epithelial Ovarian Tumors

According to the SEER Cancer Stat Facts, the death rate of ovarian cancer in 1992 was 63%, and in 2022 was 57%, a 6% absolute improvement or a 9.5% relative improvement.

Considering all the advances in medicine in 30 years, this is a very small improvement, what is the explanation?

I believe we cannot fix something that we do not understand.

In 2012, I proposed a new theory, expanded in 2016, and explained in detail in the book Fere Ex Nihilo in 2025.

This is the summary of this theory:

1-    Most ovarian epithelial tumors develop in abnormal ovaries. Pathologists concentrate in the morphology of the tumors without reviewing the residual ovary. This is obvious when early tumors are reviewed

2-    Epithelial tumors develop by mesenchymal-epithelial transition. This explains the growth of epithelial tumors in an organ that does not have epithelia.

3-    The epithelial-mesenchymal transition recapitulates the development of the Mullerian duct, induced by steroid hormones.

4-    The “dissemination” of these tumors in the peritoneum, mainly for serous tumors, at least at the beginning is due to the multicentric development of new primaries in the primary (like fallopian tube) or secondary (peritoneum) Mullerian system.

This theory explains the development of ALL the different histologic types of ovarian epithelial tumors, including benign and borderline tumors.

The lack of progress in epithelial ovarian tumors is because we evaluate them as any other epithelial tumor without realizing the they are different.