ArticleMolecular and clinical oncology2026
Low-grade serous ovarian cancer in Indonesia: Insights from the largest multicenter cohort in a middle-income country.
Article in Molecular and clinical oncology, 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
Low-grade serous ovarian cancer (LGSOC), a rare subtype of epithelial ovarian cancer, is characterized by indolent growth and limited chemosensitivity. However, data from low- and middle-income countries are limited. The present study aimed to describe the clinical and pathological characteristics of patients with LGSOC in Indonesia. This retrospective multicenter study was conducted at nine tertiary cancer centers across seven provinces, and included patients with histologically confirmed LGSOC diagnosed according to the 2020 World Health Organization Classification of Female Genital Tumors between January 2019 and December 2024. Demographic, clinical, surgical, pathological and treatment data were extracted from medical records. Recurrence was classified as early (<6 months) or late (≥6 months) after completion of primary treatment. Associations between clinicopathological variables and outcomes were analyzed using Fisher's exact test. Kaplan-Meier (KM) survival analysis with log-rank testing and Cox proportional hazards regression were performed, with a restricted multivariate model to minimize overfitting due to limited events. A total of 160 patients (median age, 46 years; range, 17-75 years) were included, with a median follow-up of 24 months. Of the cohort, ~50% presented with advanced-stage disease (International Federation of Gynecology and Obstetrics III-IV, 50%). Ascites and elevated cancer antigen-125 levels were observed in 43.1 and 70.6% of patients, respectively. Primary debulking surgery was performed in 90% of cases, achieving optimal cytoreduction in 72.5%. The overall recurrence rate was 10, and 92.5% of patients were alive at the last follow-up. KM analysis showed worse survival in patients with advanced-stage disease and residual disease. In univariate Cox regression, residual disease (HR, 7.93) and recurrence (HR, 10.06) showed the strongest associations with mortality. In multivariate analysis, only residual disease remained an independent predictor (adjusted HR, 5.59; P=0.013). In this multicenter cohort, residual disease was the key determinant of survival, underscoring the importance of complete cytoreductive surgery and early diagnosis.
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