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Residual disease after surgery linked to survival in low-grade serous ovarian cancer

Residual disease after surgery linked to survival in low-grade serous ovarian cancer
Photo by National Cancer Institute / Unsplash
Key Takeaway
Note that complete surgical resection is prognostic in low-grade serous ovarian cancer, but adjuvant chemotherapy did not improve survival in this small study.

This was an observational retrospective study conducted at a tertiary gynecologic oncology referral centre in Quebec. The population included 25 patients with low-grade serous tumour of the ovary who underwent primary cytoreductive surgery prior to adjuvant therapy. The study compared patients with no residual disease (R0), microscopic residual disease (R1), and macroscopic residual disease (R2).

Overall survival (OS) was 140.6 months in patients with no residual disease (R0), 71 months in patients with microscopic residual disease (R1), and 27.7 months in patients with macroscopic residual disease (R2) (p=.001). Progression-free survival (PFS) was also significantly impacted by residual disease status (p=.008). The administration of adjuvant chemotherapy failed to improve survival outcomes for both OS (p = .300) and PFS (p = .270).

No safety or tolerability data were reported. Key limitations include the very small sample size (n=25) and the retrospective design, which preclude causal inference. The study was conducted at a single centre, limiting external validity.

Practice relevance is restrained due to the observational nature and small cohort. The findings highlight the prognostic importance of achieving complete cytoreduction, but adjuvant chemotherapy did not show benefit in this cohort.

Study Details

Study typeCohort
Sample sizen = 25
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
Objective: The purpose of the present study is to describe the survival outcomes of patients with low-grade serous ovarian cancer (LGSOC) in the post-operative setting from a tertiary gynecologic oncology referral centre in Quebec, including evaluation of patient characteristics, clinical outcomes and prognostic factors. Methods: The study included 25 patients: 1) with a post-surgical histopathologic diagnosis of a low-grade serous tumour of the ovary, 2) underwent primary cytoreductive surgery prior to adjuvant therapy, and 3) for whom clinical data was available. Clinical and demographic features were characterized by descriptive statistics. Clinical endpoints of progression-free survival (PFS) and overall survival (OS) were assessed, utilizing the Kaplan-Meier method for estimating survival probabilities. Results: The median age of this cohort was 61 years (range, 26-81). Median OS was 140.6 months in patients with no residual disease (R0), 71 months in patients with microscopic residual disease (R1), and 27.7 months in patients with macroscopic residual disease (R2) (p=.001). Residual disease was also found to significantly impact PFS (p=.008). Administration of adjuvant chemotherapy failed to improve survival outcomes altogether (PFS, p = .270; OS, p = .300). Conclusions: This study supports the shifting consensus that optimal cytoreductive surgery, where feasible, is paramount for successful treatment of LGSOC. Furthermore, treatment with adjuvant chemotherapy may lead to worse survival outcomes.
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