Complete pathological response and long-term disease-free survival after neoadjuvant chemotherapy in advanced high-grade serous ovarian carcinoma: a case report

Abstract

Background. High-grade serous ovarian carcinoma is often diagnosed at an advanced stage, in which optimal cytoreduction, defined as no gross residual disease following surgery, is critical for survival. In patients with high tumor burden, neoadjuvant chemotherapy followed by interval debulking surgery is a valid alternative. Objectives. To describe a rare case of complete pathological response after neoadjuvant chemotherapy and its prognostic implications. Case report. A 75-year-old woman was diagnosed with FIGO stage IIIC high-grade serous ovarian carcinoma. Due to poor performance status and extensive disease, she received four cycles of platinum–taxane-based neoadjuvant chemotherapy, resulting in a complete radiologic response according to RECIST 1.1 criteria. Interval debulking surgery achieved complete cytoreduction, and histopathology confirmed a complete pathological response. Adjuvant and maintenance therapy were not administered, as the patient declined further treatment. After approximately six years of follow-up, the patient remains disease-free. Conclusions. Complete pathological response after neoadjuvant chemotherapy is rare and may predict prolonged disease-free survival, warranting further investigation into predictors of treatment response.