Fallopian Tubes Found to be Site of Origin for Most Ovarian Cancers

This year, over 22,000 women will be diagnosed with ovarian cancer but a new study conducted by researchers at Perlmutter Cancer Center at NYU Langone Health suggests that most of these malignancies begin in another part of the reproductive system: the fallopian tubes. The multicenter study – the results of which were published in the journal, Nature Communications – focused on the analysis of ovarian cancer genetics to trace their anatomical origins.

“Based on a better understanding of its origins, our study suggests new strategies for the prevention and early detection of ovarian cancer,” said senior study author Dr. Douglas A. Levine, director of the Division of Gynecologic Oncology at Perlmutter and professor of Obstetrics and Gynecology at NYU School of Medicine.

In their study, Levine and his colleagues compared the genetic profile of ovarian cancer cell samples collected from nearly 100 patients at Memorial Sloan Kettering Cancer Center, Johns Hopkins Hospital and University Health Network, with those patients’ fallopian tube epithelial cells and those collected from the surface of the ovaries. They found that the tumor cells were more genetically similar to the fallopian tube cells, compared to the ovarian tissue.

“We found no differences in the 20,000 genes that we can identify,” said Levine. “This leads us to believe that these ovarian cancers all originate in the fallopian tubes.”

According to the researchers, this finding could support the future development of diagnostics capable of detecting ovarian cancer in its earliest stages. If they’re able to identify biomarkers of the disease in the fallopian tubes, blood tests and other tools could be developed to detect ovarian cancer.

Their findings also suggest that it may be possible to proactively remove a woman’s fallopian tubes – without doing a full hysterectomy – to prevent ovarian cancer. This could be an especially important option for those who carry a BRCA mutation, which have been associated with an increased risk of breast and ovarian cancers.

“We are one of several centers taking part in Women Choosing Surgical Prevention or WISP trial, which seeks to determine whether removing the tubes improves quality of life, compared to removing both the tubes and ovaries,” said Levine.

Levine and his team have a long road ahead of them before diagnostics based on fallopian tube cell samples are used in the clinic to detect ovarian cancer. He says that they’ll need to conduct further studies to demonstrate whether it can identify ovarian cancer earlier or extend patient survival. Like most cancers, ovarian tumors are most treatable when caught early, however current diagnostics often aren’t able to detect abnormal cells in the first stages of disease.