Risk of Malignancy Index 3 (RMI3) Performance as a Predictor Advanced Stage Epithelial Ovarian Carcinoma used for NACT

Abstract

Objective: To find a non-invasive method in determining preoperative NACT administration. The method used is RMI 3 diagnostic scoring where this method can be used at the beginning of the examination and the results do not require a long time. assessed whether RMI3 performance can be used as a predictor of advanced epithelial ovarian carcinoma in the interest of NACT. Methods:A cross-sectional study with samples of all patients suffering from ovarian cancer for the past 5 years, from January 2016 to January 2020 who had been diagnosed at the Gynecology Polyclinic using medical record data from the Gynecology Oncology Polyclinic and Anatomical Pathology Laboratory, RSUD dr. Saiful Anwar in the form of age, demographics, menopausal status, Ca125, ultrasound results. Data is processed using SPSS version 25.0. Results:The number of initial samples of this study was 253 women, but after being included in the inclusion and exclusion criteria, there were 106 samples. After staging by an authorized clinician, there were 48 patients with early stage and 58 patients with advanced stage. Between the results of the RMI 3 score and the histopathological results on the ROC curve, it was found that the p-value was less than 0.05 (p<0.05) with an area of 0.945 and 95% CI of 0.907 -0.982. P-value less than 0.05 indicates that the RMI3 score is very good for predicting advanced epithelial ovarian carcinoma. With a sensitivity value of 86% and a specificity of 83%, the cut of value RMI score 3 to be a predictor of advanced ovarian carcinoma is 888.3 and PPV 86.2%, NPV 83.3% and an accuracy value of 84.9%. Conclusion:RMI 3 is very good to be used as a predictor of advanced ovarian carcinoma so that it is expected to be a reference for the administration of neoadjuvant chemotherapy in primary ovarian carcinoma which is predicted to be less likely to achieve optimal cytoreduction if surgery is performed to reduce the risk of mortality, morbidity and bad prognosis.

Malignancy Risk Index 4 (RMI 4) is better than RMI 3 as a predictor Advanced Epithelial Ovarian Carcinoma was used for NACT

“…women with an RMI 3 value limit of 888.3 have a risk of advanced ovarian malignancy, so that the lowest score of RMI 3 can be used as a reference for administering neoadjuvant therapy prior to diagnosis during surgery to prove histopathological results. [9] This is in line with the research conducted by Petronella which said that women with an RMI value below 200 had a low risk of malignancy and therefore did not require surgery for histopathological examination of frozen section. [22] RMI 4 can be used as a predictor of advanced epithelial ovarian carcinoma with a pvalue <0.05 and a positive predictive value (PPV) of 89.3% and a negative predictive value of 84.0%.…”

“…The lowest value of RMI 3 that can be used as a reference limit to determine advanced stage Epithelial Ovarian Carcinoma is 888.3. [9] In other study RMI4 score is very good to be used in predicting the stage of Epihteal Ovarian Carcinoma. The best cut off point RMI 4 that can be used as a reference limit to determine advanced stage Epithelial Ovarian Carcinoma is 2982.…”