Classification of High-Grade Serous Ovarian Cancer Using Tumor Morphologic Characteristics

Despite the similar histologic appearances of high-grade serous ovarian cancers (HGSOCs), clinical observations point to marked differences in their gross appearances. Some patients have numerous small nodules, whereas others have bulkier disease; some patients have widespread disease, whereas others have more localized disease. However, a systematic framework for classifying such gross morphologic differences does not exist. The implementation of a laparoscopic triage algorithm for patients with advanced HGSOC enabled us to prospectively obtain detailed video images of HGSOC that could be analyzed to identify morphologic subtypes. In this study, we aimed to develop and characterize a gross morphologic classification system for HGSOC. Specifically, we assessed whether HGSOC can be reliably divided into distinct gross morphologic subtypes and whether such subtypes have different clinical outcomes and molecular features.