Tumour morphology after neoadjuvant chemotherapy as a predictor of survival in serous ovarian cancer: an experience from a tertiary care centre in India
- Author:
Binny Khandakar
;
Lalit Kumar
;
Sunesh Kumar
;
Siddharth Datta Gupta
;
Kalaivani M
;
Venkateswaran K Iyer
;
Sandeep R Mathur
- Publication Type:Journal Article
- Keywords:
Serous ovarian cancers;
neoadjuvant chemotherapy;
morphological response
- From:The Malaysian Journal of Pathology
2015;37(2):115-121
- CountryMalaysia
- Language:English
-
Abstract:
Serous ovarian cancer is the most common malignant ovarian tumour. Traditional management consists
of surgical resection with postoperative chemotherapy. Currently neoadjuvant chemotherapy is offered
to patients with advanced stage disease. The present study aims to analyse the histomorphological
alterations in serous ovarian cancer following neoadjuvant chemotherapy. Correlation of these
morphological alterations with survival is also presented here. Serous ovarian cancers from 100
advanced stage cases were included; 50 were treated with pre-surgery chemotherapy. Semi-quantitative
scoring was used to grade the alterations in tumour morphology. Survival data was correlated with
the final morphological score. Tumour morphology was significantly different in cases treated with
neoadjuvant chemotherapy (CT group) as compared to cases with upfront surgery. The CT group
cases showed more fibrosis, calcification, and infiltration by lymphocytes, plasma cells, foamy
and hemosiderin-laden macrophages. The residual tumour cells had degenerative cytoplasmic
changes with nuclear atypia. Patients with significant morphological response had a longer median
survival, although it did not attain statistical significance in the current study. With the increasing
use of neoadjuvant chemotherapy in management, the pathologist needs to be aware of the altered
morphological appearance of tumour. Further studies are required to establish a grading system to
assess the tissue response which can be helpful in predicting the overall therapeutic outcome and
the prognosis of patients.
- Full text:P020150915629266497135.pdf
