RMI and ROMA are equally effective in discriminating between benign and malignant gynecological tumors: A prospective population‐based study

Liest, Ann-Lisbeth; Omran, Ahmed Shaker; Mikiver, Rasmus; Rosenberg, Per; Uppugunduri, Srinivas

doi:10.1111/aogs.13462

Cited by 10 publications

(9 citation statements)

References 33 publications

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“…In the cohort of 33 patients with recorded values of both pre-and postoperative tumor markers the median levels of HE4 significantly decreased to well under upper reference limit (URL) in the group in which complete debulking was achieved (n = 28) compared to the group (n = 5) left with minimal or bulky disease (P<0.001, Fig.1A-B). In the present study, we have used 82 pmol/L as the URL in accordance with conclusions from our previous study [12]. The four patients left with bulky disease had postoperative HE4 values, which were well above the URL.…”

Section: Levels Of He4 and Ca125mentioning

confidence: 78%

Prospective study of the role of HE4 and CA125 in treatment and follow-up in ovarian cancer patients

Liest

Rosenberg

Omran

et al. 2020

Preprint

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Introduction: Epithelial Ovarian Cancer, tubal- and peritoneal cancer (EOC) is still the major cause of death in gynecological cancer. The outcome of primary surgery is an important prognostic factor. The primary aim of this study was to study the utility of HE4 and CA125 in monitoring the response of chemotherapy during treatment and in predicting prognosis and recurrence during follow-up. We have also evaluated the role of HE4 as a predictor of the result of surgical intervention. Methods: Seventy-eight patients scheduled for chemotherapy were monitored with serum HE4 and CA125 during treatment and follow-up. In 39 patients samples for tumor markers were also obtained prior to surgical intervention. Results: Both HE4 and CA125 decreased in response to treatment. PFS and OS were strongly dependent on HE4 levels prior to start of chemotherapy with significantly prolonged PFS and OS when HE4 levels were under upper reference limit of 82 pmol/L (P=0.018 resp. P<0.001). The levels of HE4 correlated with primary surgical outcome with significantly lower postoperative HE4 in the radically operated group (P<0.001). An increase in HE4 and/or CA125, signals a recurrence 3-6 months before diagnosis. Median levels for both HE4 and CA125 before start, during and at the end of treatment were significantly higher for platinum resistant patients (P<0.005). Conclusion: Both tumor markers are valuable in monitoring the response of chemotherapy as well as in predicting recurrence during follow-up. Postoperative HE4 holds promise as an objective marker to evaluate the result of surgery and is highly predictive for future prognosis.

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Section: Levels Of He4 and Ca125mentioning

confidence: 78%

Prospective study of the role of HE4 and CA125 in treatment and follow-up in ovarian cancer patients

Liest

Rosenberg

Omran

et al. 2020

Preprint

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“…1A-B). In the present study, we have used 82 pmol/L as the URL in accordance with conclusions from our previous study [12]. The four patients left with bulky disease had postoperative HE4 values, which were well above the URL.…”

Section: Levels Of He4 and Ca125mentioning

confidence: 78%

Prospective study of the role of HE4 and CA125 in treatment and follow-up in ovarian cancer patients

Liest¹,

Omran²,

Rosenberg³

et al. 2020

OGIJ

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Introduction: Epithelial Ovarian Cancer, tubal- and peritoneal cancer (EOC) is still the major cause of death in gynecological cancer. The outcome of primary surgery is an important prognostic factor. The primary aim of this study was to study the utility of HE4 and CA125 in monitoring the response of chemotherapy during treatment and in predicting prognosis and recurrence during follow-up. We have also evaluated the role of HE4 as a predictor of the result of surgical intervention. Methods: Seventy-eight patients scheduled for chemotherapy were monitored with serum HE4 and CA125 during treatment and follow-up. In 39 patients samples for tumor markers were also obtained prior to surgical intervention. Results: Both HE4 and CA125 decreased in response to treatment. PFS and OS were strongly dependent on HE4 levels prior to start of chemotherapy with significantly prolonged PFS and OS when HE4 levels were under upper reference limit of 82pmol/L (P=0.018 resp. P<0.001). The levels of HE4 correlated with primary surgical outcome with significantly lower postoperative HE4 in the radically operated group (P<0.001). An increase in HE4 and/or CA125, signals a recurrence 3-6months before diagnosis. Median levels for both HE4 and AC125 before start, during and at the end of treatment were significantly higher for platinum resistant patients (P<0.005). Conclusion: Both tumor markers are valuable in monitoring the response of chemotherapy as well as in predicting recurrence during follow-up. Postoperative HE4 holds promise as an objective marker to evaluate the result of surgery and is highly predictive for future prognosis.

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“…When the studies conducted in the literature about the use of combined tests are examined, it is observed that there are different results Jacobs et al [10] reported the sensitivity of RMI as 85% and specificity as 97% in a study involving 101 benign and 42 malignant ovarian tumors. In another study conducted by Liest et al [11], it was shown that ROMA and RMI tests did not have superiority over each other in the preoperative malignant-benign differentiation of the adnexal mass of 784 patients. While in another study conducted on 457 patients with an adnexal mass, the ROMA test was superior to RMI (sensitivity 89% vs. 80.7%) [12].…”

Section: Discussionmentioning

confidence: 92%

Serum markers, morphological index, RMI, and ROMA in preoperative diagnosis of ovarian cancer

BASTEMUR¹,

Ciplak²,

Melekoğlu³

et al. 2022

Journal of Surgery and Medicine

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Background/Aim: Ovarian cancer is the second most common gynecologic malignancy worldwide and is the deadliest among gynecological cancers. It is important that this cancer, which is usually diagnosed in advanced stages, is referred to a gynecologist oncologist without delay. An ideal screening method does not yet exist. Although CA 125 is still the most used tumor marker, it cannot detect early-stage ovarian cancer. Also, CA 125 is not specific for ovarian malignancy. Therefore, new serum markers, such as HE4, and more complex algorithms, like ROMA and RMI, have emerged. Here we evaluate the preoperative potential of patients with adnexal mass to have a malignant or benign mass with morphological index, CA 125, HE4, RMI, and ROMA tests. Methods: This study is a prospective cohort study. A power analysis was done before starting the study. The sample size was at least 80 when the Type I error was set at 0.05, and the confidence interval was 95%. We included into the study 84 patients admitted to our clinic because of pelvic mass and underwent operation between March 2016 and October 2018. To homogenize the benign and malignant groups, 42 patients were collected from each group. CA 125 and HE4 levels of the samples were studied by the electrochemiluminescence method. ROMA and RMI values were calculated, and the data were entered into SPSS. Data were analyzed using SPSS 22.0 statistical package program. Results: Each of the CA 125 (P = 0.002), HE4 (P < 0.001), morphological index (P < 0.001), ROMA (P < 0.001), and RMI (P < 0.001) tests has been successful in differentiating malignant masses from benign masses. In the malignant-benign differentiation of adnexal masses preoperatively, CA 125 was the test with the lowest sensitivity, and RMI had the highest sensitivity. However, in the ROC analysis, the morphological index has a higher area under the curve. Conclusion: Although CA 125 is still the most frequently used marker in the preoperative evaluation of adnexal masses, it has low specificity and sensitivity, especially in premenopausal patients. The use of new tumor markers (e.g., HE4) and other algorithms (e.g., ROMA and RMI) is supported by our findings and the literature. However, here we show that an expert ultrasonographic evaluation with morphological index alone could be effective.

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RMI and ROMA are equally effective in discriminating between benign and malignant gynecological tumors: A prospective population‐based study

Cited by 10 publications

References 33 publications

Prospective study of the role of HE4 and CA125 in treatment and follow-up in ovarian cancer patients

Prospective study of the role of HE4 and CA125 in treatment and follow-up in ovarian cancer patients

Prospective study of the role of HE4 and CA125 in treatment and follow-up in ovarian cancer patients

Serum markers, morphological index, RMI, and ROMA in preoperative diagnosis of ovarian cancer

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