Evaluation of a risk of malignancy index based on serum CA125, ultrasound findings and menopausal status in the pre‐operative diagnosis of pelvic masses

Tingulstad, Solveig; Hagen, Bjørn; Skjeldestad, Finn Egil; Onsrud, Mathias; Kiserud, Torvid; Halvorsen, Tore; Nustad, Kjell

doi:10.1111/j.1471-0528.1996.tb09882.x

Cited by 311 publications

(250 citation statements)

References 18 publications

(33 reference statements)

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“…Ideally patients with ovarian malignancy should be operated by a gynecologic oncologist or referred to a cancer center. However in practice, preoperative diagnosis of malignancy is not so easy (Tingulstad et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

Pre-Operative Evaluation of Ovarian Tumors by Risk of Malignancy Index, CA125 and Ultrasound

Arun-Muthuvel¹,

Vijayaraghavan²

2014

Asian Pacific Journal of Cancer Prevention

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Purpose: To evaluate the diagnostic performances of risk of malignancy index (RMI), CA-125 and ultrasound score in differentiating between benign and borderline or malignant ovarian tumors and find the best diagnostic test for referral of suspected malignant ovarian cases to gynaecologic oncologists. Materials and Methods: This prospective study covered 467 women with pelvic tumors scheduled for surgery at our hospital between July 2011 and July 2013. The RMI was obtained from ultrasound score, CA125 and menopausal status. The diagnostic values of each parameter and the RMI were determined and compared using Statistical Packages for Social Sciences Version 14.0.1. Results: In our study, 61% of ovarian tumors were malignant in the post-menopausal age group. RMI with a cut-off 150 had sensitivity of 84% and specificity of 97% in detecting ovarian cancer. CA-125>30 had a sensitivity of 84% and a specificity of 83%. An ultrasound score more than 2 had a sensitivity of 96% and specificity of 81%. RMI had the least false malignant cases thus avoiding unnecessary laparotomies. Ultrasound when used individually had the best sensitivity but poor specificity. Conclusions: Our study has demonstrated the RMI to be an easy, simple and applicable method in the primary evaluation of patients with pelvic masses. It can be used to refer suspected malignant patients to be operated by a gynaecologic oncologist. Other models of preoperative evaluation should be developed to improve the detection of early stage invasive, borderline and non-epithelial ovarian cancers.

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Section: Introductionmentioning

confidence: 99%

Pre-Operative Evaluation of Ovarian Tumors by Risk of Malignancy Index, CA125 and Ultrasound

Arun-Muthuvel¹,

Vijayaraghavan²

2014

Asian Pacific Journal of Cancer Prevention

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“…In comparison to Jacobs et al 12 , sensitivity was 78% vs 71% and specificity was 80% vs 83% . Sensitivity 78% vs 68% and specificity 80% vs 82% were found in comparison to Tingulstad et al 9 . In relation to third research of Morgante et al 10 sensitivity and specificity were found 78% vs 71% and 80% vs 87% respectively .These small variations may be acceptable .…”

Section: Discussionmentioning

confidence: 76%

Sonographic Prediction of Ovarian Malignancy in Adnexal Mass

Nahar

Shamsuddin

Faruqui

et al. 2016

Bangladesh J Obstet Gynaecol

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Objective: To evaluate the role of ultrasound for preoperative diagnosis of ovarian malignancy in adnexal mass.Materials & Methods: This prospective observational study was conducted on patients having adnexal mass (n-57) admitted consecutively for surgical exploration in Dept. of OB-GYN of BSMMU from January 2000 - March 2001. Abdominal ultrasonography was performed 10 days preoperatively and 5 sonographic criteria were used to calculate ultrasound score (0, 1 & 3 ). Definitive diagnosis was based on histo-pathological study . Sensitivity , specificity , positive and negative predictive values of ultrasound score to diagnose ovarian malignancy were detected . Chi square & students t test were used for statistical analysis .Results: Sensitivity , specificity , positive and negative predictive values of ultrasound score at cut-off value of 3 were 78% , 80% , 47% and 94 % respectively .Conclusion: For pre-operative diagnosis of ovarian malignancy sonographic scoring system may be introduced easily into the clinical practice where other complementary tests are not available. Combination of serum CA125 and menopausal status into ultrasound score may further improve the diagnostic accuracy in prediction of ovarian malignancy preoperatively.Bangladesh J Obstet Gynaecol, 2012; Vol. 27(2) : 67-71

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“…Referral of all pelvic masses would create logistical problems. Instead, pelvic masses with a small chance of being malignant can be distinguished from malignant tumors by using the Risk of Malignancy Index (RMI) [21]. Only patients with a RMI above the cutoff-level should be referred or operated in the hospital of diagnosis by a consulting specialized gynecologist.…”

Section: Discussionmentioning

confidence: 99%