Variations in the Management of Low-Grade Serous Carcinoma of the Ovary: A Global Survey

Abstract Objective Low-grade serous carcinoma (LGSOC) constituting < 15% of ovarian or peritoneal serous carcinomas differs distinctly from high-grade serous ovarian carcinoma (HGSOC). This global survey investigates the variations in managing LGSOC, acknowledging its unique characteristics and the absence of a consensus on optimal management. Methods A voluntary non-incentivized global survey gathered responses from 203 practitioners across 50 countries and 7 continents. Approved by the Institutional Ethics Committee, it encompassed 21 questions focusing on demographics, diagnosis, and management practices. Descriptive statistics and Fisher’s exact test analyzed the data. Results Demographically diverse responses were obtained with the majority from India (39.9%) and Colombia (5.4%). Gynecologic oncologists predominated (73.10%), with varied practice settings. Most practitioners considered LGSOC distinct (95.57%). Diagnosis criteria showed institutional variations. In managing apparent inoperable stage III C LGSOC approaches varied: neoadjuvant chemotherapy (54.78%), upfront surgery (35.69%), and neoadjuvant hormone therapy (8.54%). Adjuvant management demonstrated heterogeneity. Notably, there was no significant association between the continent and the offered adjuvant treatment for optimally cytoreduced stage III C LGSOC ( p = 0.556; Fisher’s exact test). For recurrent disease, hormonal therapy (30.54%) and chemotherapy (27.59%) were common choices. MEK inhibitors were infrequently used. Fertility preservation was favored (71%), and HIPEC was not widely considered (81.28%). Genetic testing opinions varied: routine testing (28.7%), no recommendation (45.32%), and testing in recurrent settings (16.75%). Conclusion This survey exposes global disparities in LGSOC management, highlighting the need for standardized guidelines to address challenges in diagnosis and management. International collaboration is advocated to enhance uniformity in healthcare practices for LGSOC.