Prognostic value of chemotherapy response score in advanced ovarian cancer: a single-center retrospective analysis

The chemotherapy response score (CRS) is a histopathological tool used to assess the tumor response in patients with high-grade serous ovarian carcinoma (HGSC) undergoing neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS).

This single-center retrospective study was conducted at the Faculty of Medicine at Istanbul University. The study included patients treated between January 1, 2010, and December 31, 2017 at a tertiary care hospital specializing in gynecologic oncology.

This study aimed to evaluate the prognostic significance of omental and adnexal CRS in predicting overall survival (OS) and disease-free survival (DFS) in patients with advanced HGSC undergoing NACT followed by IDS.

Data from 79 patients with advanced HGSC treated with NACT followed by IDS between 2010 and 2017 were analyzed. CRS was applied to both omental and adnexal samples, and its association with OS and DFS was evaluated. Statistical analyses were performed using univariate and multivariate methods with a significance level of P < 0.05.

Omental CRS 1-2 was identified as an independent predictor of decreased OS (hazard ratio 2.69; 95% confidence interval 1.26-5.76, P = 0.010), whereas adnexal CRS 1-2 did not significantly impact DFS or OS in multivariate analysis. Patients with omental CRS 3 had superior outcomes, with a 5-year OS rate of 72%, compared to 30.8% in the CRS 1-2 group. The median DFS of the CRS 1-2 group was 19 months, whereas that of the CRS 3 group was 35 months (P = 0.005).

Omental CRS is a strong independent predictor of OS in patients with advanced HGSC, whereas adnexal CRS has limited prognostic value. CRS should be considered in clinical practice to guide treatment decisions, and further research is warranted to refine its use by using molecular and radiological markers.