Prognostic Value of Chemotherapy Response Score in Advanced Ovarian Cancer: A Single-Center Analysis

Purpose Chemotherapy response score (CRS) is a histopathological tool to assess tumor response in patients with high-grade serous ovarian carcinoma (HGSC) undergoing neoadjuvant chemotherapy (NACT) followed by interval debulking surgery (IDS). This study aimed to evaluate the prognostic significance of omental and adnexal CRS for predicting overall survival (OS) and disease-free survival (DFS). Methods Data from 79 patients with advanced HGSC treated with NACT followed by interval debulking surgery (IDS) between 2010 and 2017 were analyzed. CRS was applied to both omental and adnexal samples, and its association with OS and DFS was evaluated. Statistical analyses were performed using univariate and multivariate methods, with a significance level of p < 0.05. Results Omental CRS 1–2 was identified as an independent predictor of decreased OS (HR 2.69; 95% CI 1.26–5.76, p = 0.010), whereas adnexal CRS 1–2 did not significantly impact DFS or OS in multivariate analysis. Patients with omental CRS 3 had superior outcomes, with a 5-year OS rate of 72.0% compared to 30.8% in the CRS 1–2 group. The median DFS for the CRS 1–2 group was 19 months, while it was 35 months for the CRS 3 group (p = 0.005). Conclusion Omental CRS is a strong independent predictor of OS in advanced HGSC, while adnexal CRS demonstrated limited prognostic value. CRS should be considered in clinical practice for guiding treatment decisions, and further research is warranted to refine its use with molecular and radiologic markers.