Neoadjuvant chemotherapy for low-grade serous carcinoma of the ovary or peritoneum

Gynecol Oncol. 2008 Mar;108(3):510-4. doi: 10.1016/j.ygyno.2007.11.013. Epub 2007 Dec 26.


Objective: To evaluate the response of women with low-grade serous carcinoma of the ovary or peritoneum to platinum-based neoadjuvant chemotherapy.

Methods: Using institutional databases, we identified 25 women with advanced low-grade serous carcinoma of the ovary or peritoneum treated with neoadjuvant platinum-based chemotherapy between 1989 and 2006. Demographic and clinical variables were abstracted from the medical records. Progression-free survival (PFS) and overall survival (OS) were estimated using the method of Kaplan and Meier.

Results: Median patient age at diagnosis was 45 years (range 29-81). The majority of patients (n=19, 76%) received a combination of a taxane and platinum drug. A median of six cycles of chemotherapy was administered (range 2-16). Of the 20 patients for whom pre- and post-neoadjuvant chemotherapy CA-125 levels were available, 50% had a >50% reduction after neoadjuvant chemotherapy. However, radiographic survey of the 24 patients evaluable at the completion of neoadjuvant chemotherapy demonstrated one patient (4%) with a complete response, 21 (88%) with stable disease and 2 (8%) with progression following neoadjuvant chemotherapy. Median PFS and OS for all patients were 21.4 and 56.1 months, respectively.

Conclusions: The low response rate to platinum-based neoadjuvant chemotherapy observed indicates that low-grade serous carcinoma is not as responsive to conventional chemotherapy as high-grade serous carcinoma. Prospective clinical trials focused specifically on low-grade serous carcinoma are needed to make meaningful advances in the treatment of this disease.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Cystadenocarcinoma, Serous / drug therapy*
  • Cystadenocarcinoma, Serous / mortality
  • Cystadenocarcinoma, Serous / pathology
  • Databases, Factual
  • Disease-Free Survival
  • Drug Administration Schedule
  • Female
  • Humans
  • Medical Records
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / mortality
  • Ovarian Neoplasms / pathology
  • Peritoneal Neoplasms / drug therapy*
  • Peritoneal Neoplasms / mortality
  • Peritoneal Neoplasms / pathology
  • Retrospective Studies
  • Survival Analysis
  • Texas
  • Treatment Outcome