Pournara, Stefania (2025) ‘‘ Comparative Survival Outcomes in Low-Grade Serous Ovarian Carcinoma: Primary Debulking Surgery versus Neoadjuvant Chemotherapy with Interval Debulking Surgery’’. thesis, Medicine.
Full text available on request.Abstract
Even though low-grade serous ovarian carcinoma (LGSC) presents distinct molecular and clinical characteristics from its high-grade counterpart (HGSC), current strategies are mainly adapted from HGSC, including primary debulking surgery (PDS) with adjuvant chemotherapy or neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). However, emerging evidence suggests a limited chemosensitivity of LGSC, warranting an evaluation of the optimal treatment approach. This retrospective study analyzed national cancer registry data to compare survival outcomes between PDS and NACT+IDS in LGSC patients in the Netherlands and to evaluate the impact of cytoreduction completeness on overall survival (OS) and progression-free survival (PFS), within and between each treatment group. Among 416 eligible patients, five-year OS was significantly higher in the PDS cohort (78.5%) compared to the NACT+IDS cohort (49.3%) (adjusted hazard ratio [aHR]: 2.00, 95% CI: 1.28–3.13). Patients with complete cytoreduction had the best survival outcomes (five-year OS of 79.9%), irrespective of the type of debulking surgery, while optimal IDS appeared to be less favorable than non-optimal PDS. Furthermore, NACT+IDS was associated with significantly worse PFS (aHR: 2.30, 95% CI: 1.52–3.49) compared to PDS. Our findings suggest that primary debulking surgery should be prioritized whenever feasible, while the use of neoadjuvant chemotherapy should be restricted. Further prospective studies are required to validate these results and contribute to the development of tailored guidelines for LGSC to optimize survival outcomes.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Kruse, Dr. Arnold and Wenzel, Dr. Hans |
| Faculty: | Medical Sciences |
| Date Deposited: | 24 Apr 2026 13:49 |
| Last Modified: | 24 Apr 2026 13:49 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3933 |
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