**1. Introduction**

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142 Contemporary Gynecologic Practice

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Because of the poor prognosis for ovarian cancer due to the fact it is most often diagnosed late at an advanced stage, screening and early detection could likely reduce the mortality rate. Epithelial ovarian cancer represents 90% of all ovarian cancers [1, 2]. Initialy divided into a double-pathway, epithelial subtypes are in fact distinct diseases with specific characteristics and molecular signatures (see tables 1 and 2) [3, 4]. Recent persuasive data support the idea that high grade serous carcinoma (HGSC) may arise from the Fallopian tube epithelium whereas endometrioid and clear cell cancers could arise from atypical endometriosis through the Fallopian tube. Opportunistic salpingectomy could reduce both HGSC, and endometriosisassociated ovarian cancers (EAOC) (i.e. endometrioid and clear cell cancers).


**Table 1.** Diagram of double-pathway oncogenesis [2]

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**Table 2.** Diagram of quintuple-pathway oncogenesis [3, 4]. This classification shows the clinico-pathological differences along with potential therapeutic targets for each histological sub-type. An advantage of this new classification is that it describes the heterogeneous nature of ovarian cancer.

We propose to discuss the origin of HGSC and EAOC cancers and the potential clinical implications.
