ArticleCureus2026
Correlation Between Histopathology and Chemotherapy Response in Epithelial Ovarian Tumors.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEpithelial ovarian carcinoma comprises biologically distinct histological subtypes with differing chemosensitivity; however, neoadjuvant carboplatin-paclitaxel is commonly administered using uniform treatment protocols.
aimThis study aimed to determine whether histopathological subtype predicts multimodal response to neoadjuvant carboplatin-paclitaxel in advanced epithelial ovarian carcinoma.
methodsIn this prospective-retrospective observational study, 126 women with advanced epithelial ovarian carcinoma received platinum-taxane neoadjuvant chemotherapy followed by interval debulking surgery. Histological subtype, radiological response based on Response Evaluation Criteria in Solid Tumors (RECIST), serum cancer antigen 125 (CA-125) kinetics, omental and adnexal Chemotherapy Response Score (CRS 1-3), and extent of cytoreduction were recorded. Associations with histological subtype were analyzed using chi-square tests and analysis of variance (ANOVA).
resultsHigh-grade serous carcinoma (107/126, 84.9%) was the most common subtype, followed by low-grade serous carcinoma (12/126, 9.5%); mucinous, endometrioid, and clear cell tumors were infrequent. High-grade serous carcinomas demonstrated significant tumor shrinkage, marked decline in CA-125 levels, and predominantly CRS 2-3 responses. Low-grade serous and mucinous tumors showed minimal radiological regression, little change in CA-125, and uniformly CRS 1 responses. Endometrioid and clear cell tumors also showed CRS 1 responses but achieved favorable cytoreduction, although case numbers were very small. Optimal cytoreduction was achieved in 77/107 (72.0%) high-grade serous, 9/12 (75.0%) low-grade serous, 1/3 (33.3%) mucinous, and all endometrioid (3/3, 100.0%) and clear cell tumors (1/1, 100.0%). Neoadjuvant chemotherapy and surgery were well tolerated, with no treatment-related or perioperative mortality.
conclusionHistopathological subtype is a major determinant of response to neoadjuvant carboplatin-paclitaxel in epithelial ovarian carcinoma. Integrating RECIST response, CA-125 kinetics, CRS, and residual disease provides a pragmatic, histology-informed framework for treatment planning, particularly in settings where molecular profiling is limited.
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