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Background <p>Ovarian cancer is a leading cause of gynecological cancer mortality. Neoadjuvant chemotherapy (NACT) is employed to reduce tumor burden before cytoreductive surgery. This study evaluates histomorphological changes in ovarian epithelial malignancies post-NACT and classifies response using the Chemotherapy Response Score (CRS).</p> Materials and Methods <p>This retrospective study included 100 patients with ovarian cancer who underwent interval cytoreduction following NACT with paclitaxel and carboplatin. Stromal and nuclear histopathological changes were assessed, and tumors were classified into CRS1 (minimal response), CRS2 (partial response), and CRS3 (complete/near-complete response). Clinical parameters such as CA-125 levels, peritoneal spread, and FIGO stage were recorded.</p> Results <p>The mean age of the cohort was 55.4&#xa0;years. High-grade serous carcinoma was the predominant histology (89%). Extra-ovarian involvement was observed in 58% of cases. At diagnosis, 85% had CA-125 levels &gt; 500 U/ml, which decreased to &lt; 500 U/ml post-NACT in 72% of cases. Common stromal changes included fibrosis (71%) and necrosis (42%), while frequent nuclear changes were pyknosis (62%) and prominent nucleoli (61%). CRS classification identified 34% as CRS1, 46% as CRS2, and 20% as CRS3.</p> Conclusion <p>Post-NACT histomorphological alterations vary widely. CRS stratification provides an objective measure of response, aiding therapeutic decisions. Thorough histopathological evaluation is critical for refining ovarian cancer management and guiding patient prognosis.</p>

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Evaluation of Histomorphological Changes and Chemotherapy Response Score (CRS) in Ovarian Malignancies Post-neoadjuvant Chemotherapy

  • 期刊论文

  • 发表日期：

    2025年8月18日

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  • Shikhar Chohan,
  • Archana Mishra,
  • Pallavi Mourya,
  • Sana Ahuja,
  • Mridul Misra,
  • Sufian Zaheer

摘要

Background

Ovarian cancer is a leading cause of gynecological cancer mortality. Neoadjuvant chemotherapy (NACT) is employed to reduce tumor burden before cytoreductive surgery. This study evaluates histomorphological changes in ovarian epithelial malignancies post-NACT and classifies response using the Chemotherapy Response Score (CRS).

Materials and Methods

This retrospective study included 100 patients with ovarian cancer who underwent interval cytoreduction following NACT with paclitaxel and carboplatin. Stromal and nuclear histopathological changes were assessed, and tumors were classified into CRS1 (minimal response), CRS2 (partial response), and CRS3 (complete/near-complete response). Clinical parameters such as CA-125 levels, peritoneal spread, and FIGO stage were recorded.

Results

The mean age of the cohort was 55.4 years. High-grade serous carcinoma was the predominant histology (89%). Extra-ovarian involvement was observed in 58% of cases. At diagnosis, 85% had CA-125 levels > 500 U/ml, which decreased to < 500 U/ml post-NACT in 72% of cases. Common stromal changes included fibrosis (71%) and necrosis (42%), while frequent nuclear changes were pyknosis (62%) and prominent nucleoli (61%). CRS classification identified 34% as CRS1, 46% as CRS2, and 20% as CRS3.

Conclusion

Post-NACT histomorphological alterations vary widely. CRS stratification provides an objective measure of response, aiding therapeutic decisions. Thorough histopathological evaluation is critical for refining ovarian cancer management and guiding patient prognosis.