Risk-Based Evaluation of Adjuvant Chemotherapy in Stage I Epithelial Ovarian Cancer: A Retrospective Cohort Study

Aim: This study aims to assess the clinical utility of adjuvant chemotherapy in patients diagnosed with International Federation of Gynecology and Obstetrics (FIGO) stage I epithelial ovarian cancer (EOC), focusing on its impact on recurrence, disease-free survival (DFS), and overall survival (OS) based on patient risk stratification.Methods: A retrospective cohort of 67 patients with FIGO stage I EOC treated at a single tertiary center between January 2006 and February 2024 was analyzed.Demographic, clinical, and pathological characteristics were reviewed.DFS and OS were evaluated using Kaplan-Meier analysis, logrank tests, and Cox proportional hazards modeling.Results: Among patients with low-risk stage I disease, the 10-year DFS and OS were both 100%.High-risk patients exhibited lower survival outcomes with DFS at 78% and OS at 92%.Interestingly, 10-year survival was marginally reduced among individuals who underwent adjuvant chemotherapy compared to those who were only observed.Variation in the number of administered chemotherapy cycles showed no statistically significant impact on survival rates.Conclusion: These findings underscore the importance of risk-based therapeutic decision-making in stage I EOC.While low-risk patients may not benefit from adjuvant chemotherapy, high-risk individuals may still require tailored interventions.