ArticleThe oncologist2026
Association between pathologic chemotherapy response score and pattern of recurrence in advanced high-grade serous ovarian cancer.
Article in The oncologist, 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
backgroundChemotherapy Response Score (CRS) is a three-tier histopathologic system evaluating response to neoadjuvant chemotherapy (NACT) in high-grade serous ovarian cancer (HGSOC).
methodsWe evaluated recurrence patterns and survival outcomes in advanced-stage HGSOC patients treated with NACT and interval debulking surgery (IDS) between 2015 and 2024.
resultsAmong 238 patients, CRS3 was most frequent (43.3%) and was associated higher complete cytoreduction (CC0) rates (93%) compared to CRS2 (81%) and CRS1 (57%) (p < 0.001). Median follow-up was 35 months (IQR 12.6-42.2). Median progression-free survival (PFS) was 40.4 months for CRS3, 23.4 for CRS2, and 21.5 for CRS1 (p = 0.001). Among 109 (45.7%) patients who relapsed, 25 (23%) presented with oligometastatic disease (≤5 lesions), more frequently in CRS3 (46%) than CRS2 (8.9%) or CRS1 (15%) (p < 0.001). Specifically, peritoneal (p = 0.002) and nodal (p = 0.05) oligorecurrences were more common in the CRS3 group. CRS3 predicted oligometastatic recurrence (OR = 4.89; p = 0.008) and was associated with increased use of locoregional therapies (surgery or radiotherapy) at relapse (p = 0.014). Median overall survival (OS) was 93.9, 37.2, and 31.7 months for CRS3, CRS2, and CRS1, respectively (p < 0.001).
conclusionsCRS3 predicts lower recurrence risk, increased rates of oligometastatic relapse, and greater use of locoregional treatments in patients with recurrent HGSOC after NACT and IDS.
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