Low-Grade Serous Carcinoma of the Ovary: The Current Status

Abstract

Low-grade serous carcinoma (LGSC) of the ovary is a rare histological subtype of epithelial ovarian carcinoma. It has distinct clinical behavior and a specific molecular profile. Compared with high-grade serous carcinoma, this tumor presents at a younger age, has an indolent course, and is associated with prolonged survival. LGSC can arise de novo or originate following a serous borderline tumor (SBT). Pathological differentiation between LGSC and other ovarian carcinoma histological subtypes is fundamental. Several factors might influence the overall outcome, such as the age at diagnosis, current smoking, elevated body mass index, mutational status, hormonal receptors' expression, and Ki-67 proliferation index. Surgery is the main treatment option in LGSC, and efforts must be maximized to achieve a microscopic residual in metastatic disease. Despite being relatively chemo-resistant, adjuvant platinum-based chemotherapy remains the standard of care in LGSC. Hormonal maintenance therapy after adjuvant chemotherapy results in improved outcomes. Treatment options for disease recurrence include secondary cytoreductive surgery, chemotherapy, hormonal therapy, targeted therapy, and clinical trials. Advancements in genomic studies and targeted therapies are expected to change the treatment landscape in LGSC.

Keywords: cytoreductive surgery; grading system; low-grade serous ovarian carcinoma; molecular profile; prognostic factors; targeted therapy.

Figure 1

Microscopic feature of LGSC. (A) Micropapillary architecture outlined by cuboidal cells with mild to moderate atypia associated with low mitosis. (B) Focus on stromal invasion by the tumor with a cribriform architectural pattern. Scale bar 10 μm (20 × magnification).