Review
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Jul 26, 2019; 11(7): 383-397
Published online Jul 26, 2019. doi: 10.4252/wjsc.v11.i7.383
Presence and role of stem cells in ovarian cancer
Natasa Kenda Suster, Irma Virant-Klun
Natasa Kenda Suster, Department of Gynecology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
Irma Virant-Klun, Department of Human Reproduction, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Ljubljana 1000, Slovenia
Author contributions: All authors equally contributed to this paper with conception, literature review, analysis, drafting, editing, and final approval of the final version.
Conflict-of-interest statement: No potential conflicts of interest. No financial support.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Natasa Kenda Suster, MD, PhD, Attending Doctor, Department of Gynecology, Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Zaloska cesta 2, Ljubljana 1000, Slovenia. natasa@kenda.si
Telephone: +386-15-221172
Received: February 20, 2019
Peer-review started: February 20, 2019
First decision: April 16, 2019
Revised: April 23, 2019
Accepted: June 12, 2019
Article in press: June13, 2019
Published online: July 26, 2019
Processing time: 157 Days and 2.5 Hours
Abstract

Ovarian cancer is the deadliest gynecological malignancy. It is typically diagnosed at advanced stages of the disease, with metastatic sites disseminated widely within the abdominal cavity. Ovarian cancer treatment is challenging due to high disease recurrence and further complicated pursuant to acquired chemoresistance. Cancer stem cell (CSC) theory proposes that both tumor development and progression are driven by undifferentiated stem cells capable of self-renewal and tumor-initiation. The most recent evidence revealed that CSCs in terms of ovarian cancer are not only responsible for primary tumor growth, metastasis and relapse of disease, but also for the development of chemoresistance. As the elimination of this cell population is critical for increasing treatment success, a deeper understanding of ovarian CSCs pathobiology, including epithelial-mesenchymal transition, signaling pathways and tumor microenvironment, is needed. Finally, before introducing new therapeutic agents for ovarian cancer, targeting CSCs, accurate identification of different ovarian stem cell subpopulations, including the very small embryonic-like stem cells suggested as progenitors, is necessary. To these ends, reliable markers of ovarian CSCs should be identified. In this review, we present the current knowledge and a critical discussion concerning ovarian CSCs and their clinical role.

Keywords: Ovarian cancer; Cancer stem cells; Very small embryonic-like stem cells; Epithelial-mesenchymal transition

Core tip: Ovarian carcinoma, based on its biological profile and clinical course, presents a prototype of cancer stem-cell-driven disease. Ovarian cancer stem cells (CSCs) might be responsible for tumor formation, invasion, and metastasis, disease relapse and chemoresistance acquisition. For the successful treatment of this deadly disease, target therapy directed toward ovarian CSCs should be implemented. But to this, identification and characterisation of CSC subpopulations, such as very small embryonic-like stem cells, should be derived. This review’s objective is to consolidate present knowledge and to discuss future perspectives in the field of ovarian CSCs.