Prognostic impact of time to first recurrence in low-grade serous ovarian carcinoma: A multicentric retrospective study from the French TMRG network

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INTRODUCTION: In high-grade serous ovarian carcinoma (HGSOC), time to first recurrence is a major prognostic factor guiding therapeutic management. However, this parameter remains poorly studied in low-grade serous ovarian carcinoma (LGSOC), a rare subtype characterized by indolent progression and marked chemoresistance. Moreover, AGO criteria for selecting candidates for secondary cytoreductive surgery appear poorly applicable to LGSOC, highlighting the need for specific prognostic markers. METHODS: We conducted a multicenter retrospective study using the national LGSC database from the French Rare Malignant Gynaecologic Tumor Network. Patients with recurrent LGSOC were included. Associations between time to first recurrence, post-relapse survival (PRS), and post-relapse progression-free survival (PR-PFS) were assessed using Cox proportional hazards models adjusted for established prognostic factors. The association between time to recurrence and completeness of secondary cytoreduction was evaluated using multivariable logistic regression. RESULTS: Among 211 patients, the median time to first recurrence was 32 months (IQR 19-63). Longer recurrence intervals were associated with improved outcomes. In multivariable analysis, patients relapsing at 24-48 months (PRS: HR 0.50; 95% CI 0.25-0.97) and ≥48 months (PRS: HR 0.25; 95% CI 0.11-0.58) had significantly better survival compared with the 12-24 month group. Similar results were observed for PR-PFS, with a significant benefit for ≥48 months (HR 0.36; 95% CI 0.19-0.70). Incorporating time to recurrence improved model discrimination. Time to recurrence was not associated with completeness of secondary cytoreduction. CONCLUSION: Time to first recurrence is an independent prognostic factor in LGSOC. Its integration into prognostic models may improve patient stratification and refine selection for secondary cytoreductive surgery.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.