Efficacy of secondary cytoreductive surgery for relapsed ovarian low-grade serous carcinoma: a multicenter analysis from French TMRG network

OBJECTIVE: To evaluate the impact of secondary cytoreductive surgery (SCS) on overall survival (OS) and progression-free survival (PFS) in patients with recurrent low-grade serous ovarian cancer. METHODS: A multicenter study was conducted, including 152 patients with recurrent low-grade serous ovarian cancer treated across 31 French centers from 2002 to 2024 from the Tumeurs Malignes Rares Gynécologiques network. Patients were analyzed based on SCS status, completeness of cytoreduction (CC0 vs. CC+), and clinical outcomes. Survival analyses were performed using Kaplan-Meier estimates and Cox proportional hazards models. RESULTS: From 478 patients, a total of 152 patients with first recurrent low-grade serous ovarian cancer were included, with 39.5% undergoing SCS. Complete cytoreduction (CC0) was achieved in 92% of cases, with no difference in complication rates based on resection quality. After adjustment on confounding factors, SCS was independently associated with improved OS (adjusted hazard ratio on age [HRa]=0.28; 95% confidence interval [CI]=0.13-0.63; p