Low-grade Serous Ovarian Carcinoma

Abstract

In the early 2000s a two-tier grading system was introduced for serous ovarian cancer. Since then, we have increasingly come to accept that low-grade serous ovarian carcinoma (LGSOC) is a separate entity with a unique mutational landscape and clinical behaviour. As less than 10% of serous carcinomas of the ovary are low-grade, they are present in only a small number of patients in clinical trials for ovarian cancer. Therefore the current treatment of LGSOC is based on smaller trials, retrospective series, and subgroup analysis of large clinical trials on ovarian cancer. Surgery plays a major role in the treatment of patients with LGSOC. In the systemic treatment of LGSOC, hormonal treatment and targeted therapies seem to play an important role.

Opposite Macrophage Polarization in Different Subsets of Ovarian Cancer: Observation from a Pilot Study

“…Our findings at diagnosis where M2 TAMs are increased at metastatic sites is in line with previous literature data showing that M2 increase the invasiveness of ovarian cancer [24] and that TAM behavior, number, and composition differ according to the tumor area (demonstrated in different solid tumors, but not yet in ovarian cancer [25]). Although often treated similarly, low-grade tumors respond differently to chemotherapy compared to high-grade tumors [26], differ genetically [27], and have a different immune biology. The group of Yang et al demonstrated, based on the retrospective analysis of micro-array datasets, that the gene signature of immune cells is nearly opposite in high-grade serous ovarian cancer compared to low-grade serous ovarian cancer [28].…”

Low-grade epithelial ovarian cancer: what a radiologist should know

“…62 For recurrent LGSOCs, secondary cytoreductive surgery (SCRS) should be considered based on the time to recurrence, disease localization, number of metastases, and patient general condition. 52 SCRS without macroscopic residual disease is associated with significant better PFS and OS of 60.3 months and 167.5 months, respectively, compared to 10.7 months and 88.9 months, respectively, in patients with macroscopic residual disease after SCRS. 52 LGSOCs have poor response to conventional chemotherapy; as a result, some studies have suggested the use of bevacizumab in conjunction with platinum-based and non-platinum-based chemotherapy.…”

“…52 SCRS without macroscopic residual disease is associated with significant better PFS and OS of 60.3 months and 167.5 months, respectively, compared to 10.7 months and 88.9 months, respectively, in patients with macroscopic residual disease after SCRS. 52 LGSOCs have poor response to conventional chemotherapy; as a result, some studies have suggested the use of bevacizumab in conjunction with platinum-based and non-platinum-based chemotherapy. 63 Schmeler and colleagues 64 evaluated 17 patients with recurrent…”

“…51 Most retrospective studies suggest that LGSOCs are less sensitive to conventional platinum-based chemotherapy with a response rate of 23.1-25%. 10,52,53 Nevertheless, hormonal therapy such as follicle-stimulating hormone receptor (FSHR) and gonadotropin-releasing hormone receptor (GnRHR) targeted agents in addition to targeted molecular therapies as bevacizumab (antiangiogenesis) and selumetinib (MEK inhibitor) are novel therapeutic approaches that might represent promising alternatives in the treatment of these tumors. 3,10 Recurrence and follow-up Until now, the follow-up strategies for LGEOCs are the same as those used for ovarian cancer in general, including measuring of serum CA-125 levels, single energy and dual energy CT and FDG PET/CT ( Figures 2, 4 and 5).…”

“…64 Hormonal therapy can be an alternative for chemotherapy in recurrent LGSOCs. 52 Gershenson et al 65 studied the efficacy of hormonal therapy in recurrent…”