Accuracy in Referrals to Gynecologic Oncologists Based on Clinical Presentation for Ovarian Mass

Abstract

Ovarian cancer is one of the most lethal gynecological cancers in women due to late diagnosis. Despite technological advancements, experienced physicians have high sensitivities and specificities in subjective assessments when combining ultrasound findings and clinical history in analyzing adnexal masses. This study aims to demonstrate general obstetricians and gynecologists’ (OB/GYN) appropriateness in gynecologic oncologist referrals for malignant ovarian masses based on history and physical (H&P), imaging, and available tumor markers. Three board certified OB/GYNs were given 148 cases and determined whether or not they would refer them to a gynecologic oncologist. Results showed that OB/GYNs were 81–85% accurate in diagnosing patients with a benign or malignant disease. Among the malignant cases, reviewers had a high sensitivity ranging from 74–81% in appropriately referring a malignancy. In our study, OB/GYNs referred between 23–32% of ovarian masses to a gynecologic oncologist with only 9.5% of cases found to be malignant. Despite the high referral rates, generalists showed a high degree of sensitivity in accurately referring malignant diseases based solely on clinical experience and imaging studies, which could improve survival rates with early intervention by gynecologic oncologists.

A multidisciplinary approach remains the best strategy to improve and strengthen the management of ovarian cancer (Review)

“…At present, several diagnostic strategies are available to make a correct and timely diagnosis of ovarian cancer when recurrent symptoms are observed. The first step for a correct diagnosis of ovarian cancer is based on the collection of patient's medical history and on a correct physical exam performed by a gynecologist with expertise in gynecological oncology ( 39 , 40 ). The aim of these procedures is the collection of all relevant data about the presence of pre-existing conditions or risk factors that could increase the risk of developing ovarian cancer.…”

Laparoscopic Management of sonographically suspensious ovarian masses

“…Ovarian masses or cysts are commonly occurring, and studies had showed that 10% of women undergo an operation during their life for investigation or treatment of an ovarian mass. These masses are usually asymptomatic; however, it is diagnosed as an incidental finding during imaging for another reason, or for investigation of nonspecific abdominal or pelvic pain [1] .…”

MicroRNA‑193a‑5p exerts a tumor suppressive role in epithelial ovarian cancer by modulating RBBP6

“…Ovarian cancer is the most common cause of death among patients with female genital tumors, and consists of a variety of pathological types, of which the most common subtype is epithelial ovarian cancer (EOC) (1,2). Due to the ovary being located deep in the pelvic cavity, the early diagnosis of EOC remains difficult, and currently, there is a lack of effective screening methods; therefore, the majority of patients are diagnosed with EOC upon reaching the advanced stages (3)(4)(5).…”