Optimizing care for low-grade serous ovarian carcinoma: insights from a tertiary care centre

Abstract

Background: Low-grade serous ovarian carcinoma (LGSC) is an uncommon epithelial ovarian malignancy with distinct tumour biology, relatively indolent behaviour, frequent advanced-stage presentation and limited sensitivity to conventional chemotherapy. This study evaluated the clinicopathological profile, treatment pattern, perioperative outcomes and survival of patients with LGSC managed at a tertiary cancer centre. Methods: A retrospective review was conducted of 23 patients with histologically confirmed LGSC treated between 2014 and 2025. Demographic characteristics, clinical presentation, tumour markers, FIGO stage, disease distribution, chemotherapy response, surgical approach, completeness of cytoreduction, postoperative morbidity, recurrence and survival outcomes were analyzed descriptively. Results: The median age was 47 years. Abdominal pain was the most common presenting symptom, reported in 17 patients (73.91%). Serum CA-125 was elevated in 19 patients (82.6%), with a median value of 89 U/ml. FIGO stage III disease was present in 18 patients (78.26%). Nine patients received neoadjuvant chemotherapy; objective response was observed in only 2 patients (22.2%), while 5 had stable disease and 2 progressed. Primary cytoreductive surgery was performed in 12 patients, interval cytoreduction in 9 and staging laparotomy in 2. Complete cytoreduction was achieved in 19 patients (82.6%). Grade III morbidity occurred in 21.7%, with no Grade IV/V complications or 30-day mortality. At 36-month median follow-up, recurrence occurred in 6 patients; 3 years overall survival was 75% and disease-free survival was 66%. Conclusions: LGSC commonly presents with advanced peritoneal disease and poor chemotherapy response. Complete cytoreduction remains the key therapeutic goal.