Prognostic impact of time to first recurrence in low-grade serous ovarian carcinoma: A multicentric retrospective study from the French TMRG network
INTRODUCTION: In high-grade serous ovarian carcinoma (HGSOC), time to first recurrence is a major prognostic factor guiding therapeutic management. However, this parameter remains poorly studied in low-grade serous ovarian carcinoma (LGSOC), a rare subtype characterized by indolent progression and marked chemoresistance. Moreover, AGO criteria for selecting candidates for secondary cytoreductive surgery appear poorly applicable to LGSOC, highlighting the need for specific prognostic markers. METHODS: We conducted a multicenter retrospective study using the national LGSC database from the French Rare Malignant Gynaecologic Tumor Network. Patients with recurrent LGSOC were included. Associations between time to first recurrence, post-relapse survival (PRS), and post-relapse progression-free survival (PR-PFS) were assessed using Cox proportional hazards models adjusted for established prognostic factors. The association between time to recurrence and completeness of secondary cytoreduction was evaluated using multivariable logistic regression. RESULTS: Among 211 patients, the median time to first recurrence was 32 months (IQR 19-63). Longer recurrence intervals were associated with improved outcomes. In multivariable analysis, patients relapsing at 24-48 months (PRS: HR 0.50; 95% CI 0.25-0.97) and ≥48 months (PRS: HR 0.25; 95% CI 0.11-0.58) had significantly better survival compared with the 12-24 month group. Similar results were observed for PR-PFS, with a significant benefit for ≥48 months (HR 0.36; 95% CI 0.19-0.70). Incorporating time to recurrence improved model discrimination. Time to recurrence was not associated with completeness of secondary cytoreduction. CONCLUSION: Time to first recurrence is an independent prognostic factor in LGSOC. Its integration into prognostic models may improve patient stratification and refine selection for secondary cytoreductive surgery.
Authors
- Navid Mokarram Dorri (ORCID: https://orcid.org/0009-0008-3290-6698)
- Judicaël Hotton (ORCID: https://orcid.org/0000-0002-1656-4746)
- Thomas Gaillard (ORCID: https://orcid.org/0000-0002-7062-9379)
- Élodie Gauroy (ORCID: https://orcid.org/0009-0005-9115-712X)
- Claire Bonneau (ORCID: https://orcid.org/0000-0001-6251-286X)
- Dominique Berton-Rigaud
- Morgane Perrin (ORCID: https://orcid.org/0000-0003-3594-3554)
- Sébastien Gouy (ORCID: https://orcid.org/0000-0001-5522-1925)
- Xavier Paolettí (ORCID: https://orcid.org/0000-0002-1250-0040)
- Hélène Vegas
- Sabrina Madad-Zadeh
- Yolanda Fernández (ORCID: https://orcid.org/0000-0002-8028-3965)
- Laure Favier
- Thomas MONTASSIER
- Sheik Emambux
- Frédéric Guyon
- Enora Laas
- Fabrice Lecuru
- Florence Joly
- Isabelle Ray-Coquard
Institutions
- Inserm (FR)
- Université de Versailles Saint-Quentin-en-Yvelines (FR)
- Université Paris Cité (FR)
- Institut Gustave Roussy (FR)
- Centre Georges François Leclerc (FR)
- Centre Hospitalier Universitaire de Tours (FR)
- Institut de Cancérologie de Lorraine (FR)
- Hôpital Bretonneau (FR)
- Centre Léon Bérard (FR)
- Centre Hospitalier Universitaire de Poitiers (FR)
- Centre François Baclesse (FR)
- Centre Jean Perrin (FR)
- Institut Bergonié (FR)
- Institut Paoli-Calmettes (FR)
- Institut Jean Godinot (FR)
- Centre Hospitalier Universitaire de Rouen (FR)
- Physique des Cellules et Cancers (FR)
- Université de Rouen Normandie (FR)
- Institut Curie (FR)
Publication Details
- Journal
- Gynecologic Oncology
- Published
- 2026-06-26
- DOI
- https://doi.org/10.1016/j.ygyno.2026.06.015
- Primary Topic
- Ovarian cancer diagnosis and treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00