Prognostic Significance of Chemotherapy Response Score in Patients Undergoing Interval Debulking Surgery and Attained Complete Cytoreduction for High-Grade Serous Tubal and Ovarian Carcinoma

Abstract

Suchetha Sambasivan

Objectives The chemotherapy response score (CRS) has been described to assess the pathological response to chemotherapy in patients with high-grade serous tubal and ovarian carcinoma. The main aim of this study was to assess the prognostic significance of CRS in patients who underwent interval debulking surgery and attained complete cytoreduction.

Materials and Methods A retrospective study was conducted on patients with Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) stage IIIC and IV high-grade serous tubal and ovarian carcinomas who had undergone surgery after three to four cycles of neoadjuvant chemotherapy and attained complete cytoreduction from January 2015 to July 2018.

Results A total of 125 patients were included in the study. The median age of the patients was 52 years. There were 21 patients (16.8%) with a CRS of 1, 53 patients (42.4%) with a CRS of 2, and 51 (40.8%) patients with a CRS of 3. The median follow-up period was 77 months. The CRS applied on the omental samples showed significant correlation with progression-free survival (PFS; CRS of 1 vs. 2: median PFS, 17 vs. 22 months; hazard ratio, 1.73; and CRS of 2 vs. 3: median PFS, 22 vs. 54 months; hazard ratio, 2.32) and overall survival (OS; CRS of 1 vs. 2: median OS, 19 vs. 40 months; hazard ratio, 2.13; CRS of 2 vs. 3: median OS, 40 months vs. not reached; hazard ratio, 2.19).

Conclusion Our study confirms that the omental CRS is significantly associated with PFS and OS in patients who attained complete cytoreduction during interval debulking surgery.

Keywords

chemotherapy response score - high-grade serous carcinoma - interval debulking surgery - neoadjuvant chemotherapy - progression-free survival

Previous Presentation

A part of this study with a smaller sample size was presented as poster at the 22nd European Congress of Gynecological Oncology held in Turkey. This study was conducted with the approval of the Institutional Review Board.

Authors' Contributions

A.J.S. contributed to the conception and design of the study, acquisition of data, analysis and interpretation of data, and drafting the manuscript. S.S. contributed to the conception and design of the study, critical revision of the manuscript for important intellectual content, and supervision of the study. S.C.M. contributed to critical revision of the manuscript for important intellectual content and supervision of the study. R.P. contributed to the conception and design of the study and supervision of the study. S.R.J. contributed to the conception and design of the study and supervision of the study. F.V.J. contributed to the conception and design of the study, critical revision of the manuscript for important intellectual content, and supervision of the study. R.A.Z. contributed to acquisition of data. J.K.K.M. contributed to statistical analysis and supervision of the study.

Publication History

Received: 14 June 2024

Accepted: 20 September 2024

Article published online:
18 October 2024

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