Response and survival in patients with progressive or recurrent serous ovarian tumors of low malignant potential

OBJECTIVE: To evaluate the response to therapy and survival of patients with progressive or recurrent serous ovarian tumors of low malignant potential. METHODS: Fifty-three patients with progressive or recurrent serous ovarian tumors of low malignant potential were identified. Response was assessed and progression-free and overall survival were analyzed. The influence of clinicopathologic factors on survival was determined. RESULTS: In 49 patients with known histology of progression or recurrence, 36 (73%) had low-grade serous carcinoma, and 13 (27%) had serous ovarian tumors of low malignant potential. Forty-five patients received nonsurgical therapy and had an evaluable response. There were six (13%) patients with a complete response and six (13%) patients with a partial response. The median time to first progression or recurrence was 5.6 years. Median survival from diagnosis of first recurrence was 7.7 years. Median survival from initial diagnosis was 21 years. Nineteen (36%) patients are dead of tumor. Patients who recurred with low-grade serous carcinoma were more likely to die of tumor than those with serous ovarian tumors of low malignant potential (47% versus 0%, P = .045). Optimal cytoreduction was associated with improved survival (P = .007). CONCLUSION: Patients with progressive or recurrent serous ovarian tumors of low malignant potential have a long interval from diagnosis to progression and from progression to death, resulting in extended overall survival. Recurrence as low-grade serous carcinoma and failure to achieve optimal secondary cytoreduction were adverse prognostic factors. There were few responses to nonsurgical therapy.