Chemotherapy Response Score is a useful histological predictor of prognosis in high grade serous carcinoma

Abstract

Aim

High grade serous carcinoma (HGSC) is the most common tubal/ovarian malignant tumor usually presenting in advance stage. Interval debulking surgery (IDS) post neoadjuvant chemotherapy (NACT) has been increasingly in use for the management of these patients. Chemotherapy response score (CRS) has been proposed for grading response of tubo-ovarian HGSC to NACT on the basis of examination of IDS specimens. Our aim was to evaluate CRS in post NACT cases, assess the interobserver agreement and correlate it to overall and progression- free survival.

Methods and Results

CRS was applied by two independent pathologists on the omental and adnexal tumour tissue sections of post NACT patients of high grade serous carcinoma who underwent IDS. The assigned primary site of tumor origin was documented. The interobserver agreement and prognostic significance of CRS were evaluated. There were a total 103 cases and in 61.1% cases a fallopian tubal origin was confirmed. There were 26, 35 and 42 cases with CRS of 1, 2 and 3 respectively. The interobserver variability for CRS showed substantial agreement (kappa, 0.806). CRS showed significant correlation with progression free survival (CRS 1&2 vs 3: median survival 16 vs 18 months; p=0.004); however after controlling for debulking status, this association was not significant. CRS applied on adnexal section did not show any prognostic significance with either progression free or overall survival.

Conclusion

CRS is an easy and reproducible method of predicting the prognosis in post NACT high grade serous carcinoma patients.

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