The endometriotic tumor microenvironment in ovarian cancer

Jillian R. Hufgard Wendel, Xiyin Wang, Shannon M. Hawkins

Research output: Contribution to journalReview article

11 Scopus citations


Women with endometriosis are at increased risk of developing ovarian cancer, specifically ovarian endometrioid, low-grade serous, and clear-cell adenocarcinoma. An important clinical caveat to the association of endometriosis with ovarian cancer is the improved prognosis for women with endometriosis at time of ovarian cancer staging. Whether endometriosis-associated ovarian cancers develop from the molecular transformation of endometriosis or develop because of the endometriotic tumor microenvironment remain unknown. Additionally, how the presence of endometriosis improves prognosis is also undefined, but likely relies on the endometriotic microenvironment. The unique tumor microenvironment of endometriosis is composed of epithelial, stromal, and immune cells, which adapt to survive in hypoxic conditions with high levels of iron, estrogen, and inflammatory cytokines and chemokines. Understanding the unique molecular features of the endometriotic tumor microenvironment may lead to impactful precision therapies and/or modalities for prevention. A challenge to this important study is the rarity of well-characterized clinical samples and the limited model systems. In this review, we will describe the unique molecular features of endometriosis-associated ovarian cancers, the endometriotic tumor microenvironment, and available model systems for endometriosis-associated ovarian cancers. Continued research on these unique ovarian cancers may lead to improved prevention and treatment options.

Original languageEnglish (US)
Article number261
Issue number8
StatePublished - Aug 2018


  • Endometriosis
  • Genes
  • Hypoxia
  • Inflammation
  • Model systems
  • Ovarian cancer
  • Tumor microenvironment
  • miRNA molecules

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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