VP61.03: Evaluation of risk of malignancy index for preoperative diagnosis of ovarian cancer

BACKGROUND: Ovarian cancer is the most common gynecological cancer associated with increased mortality. Early diagnosis is the important factor in improving the survival rate. OBJECTIVE: To evaluate and compare the performance of RMI, ROMAand R-OPS. METHODS: A validation study was conducted where 60 patients with adnexal mass who were planned to undergo surgery were included. Preoperatively, RMI and ROMAand R-OPS were calculated. The diagnostic performance of each was assessed and compared. RESULTS: 60% had benign mass, 10% had borderline neoplasia and 30% had malignant lesion. In the premenopausal group, RMI had a superior performance with a sensitivity of 75%. In postmenopausal group, R-OPS had a better performance followed by ROMA. CONCLUSION: As a diagnostic tool, an algorithm combining ultrasound imaging and both the serum markers CA125 and HE4 would be more accurate in prediction of malignancy in ovarian mass.

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Efficacy of HE4, CA125, Risk of Malignancy Index and Risk of Ovarian Malignancy Index to Detect Ovarian Cancer in Women with Presumed Benign Ovarian Tumours: A Prospective, Multicentre Trial

Journal of Clinical Medicine ◽

10.3390/jcm8111784 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1784 ◽

Cited By ~ 4

Author(s):

Vincent Dochez ◽

Mélanie Randet ◽

Céline Renaudeau ◽

Jérôme Dimet ◽

Aurélie Le Thuaut ◽

...

Keyword(s):

Ovarian Cancer ◽

Likelihood Ratio ◽

Positive Likelihood Ratio ◽

Ovarian Malignancy ◽

Cancer Antigen 125 ◽

Mean Values ◽

Benign Ovarian Tumours ◽

Ovarian Tumours ◽

Risk Of Malignancy ◽

Risk Of Malignancy Index

Background: Presumed benign ovarian tumours (PBOT) are defined by the International Ovarian Tumour Analysis (IOTA) group, without suspected sonographic criteria of cancer, without ascites or metastasis. The aim is to evaluate the efficacy of human epididymis protein 4 (HE4), cancer antigen 125 (CA125), the risk of malignancy index (RMI) and the risk of ovarian malignancy index (ROMA) to predict ovarian cancer in women with PBOT. Methods: It is a prospective, observational, multicentre, laboratory-based study including women with PBOT in four hospitals from 11 May 2015 through 12 May 2016. Preoperative CA125 and HE4 plasma levels were measured for all women. The primary endpoint was the specificity of CA125 and HE4 for diagnosing ovarian cancer. The main secondary endpoints were specificity and likelihood ratio of RMI, ROMA and tumours markers. Results: Two hundred and fifty patients were initially enrolled and 221 patients were finally analysed, including 209 benign ovarian tumours (94.6%) and 12 malignant ovarian tumours (5.4%). The malignant group had significantly higher mean values of HE4, CA125, RMI and ROMA compared to the benign group (p < 0.001). Specificity was significantly higher using a combination of HE4 and CA125 (99.5%) compared to either HE4 or CA125 alone (90.4% and 91.4%, respectively, p < 0.001). Moreover, the positive likelihood ratio for combination HE4 and CA125 was significantly higher (104.5; 95% CI 13.6–800.0) compared to HE4 alone (5.81; 95% CI 2.83–11.90) or CA125 alone (6.97; 95% CI 3.91–12.41). Conclusions: The combination of HE4 and CA125 represents the best tool to predict the risk of ovarian cancer in patients with a PBOT.

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Is the Risk of Malignancy Index a predictive tool for preoperative differentiation between borderline ovarian tumor and ovarian cancer?

European Journal of Gynaecological Oncology ◽

10.31083/j.ejgo.2020.03.5197 ◽

2020 ◽

Vol 41 (3) ◽

pp. 368

Keyword(s):

Ovarian Cancer ◽

Ovarian Tumor ◽

Borderline Ovarian Tumor ◽

Predictive Tool ◽

Risk Of Malignancy ◽

Risk Of Malignancy Index

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Risk of Malignancy Index is not accurate as a Triage Tool for Ovarian Cancer

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v2i1.380 ◽

2014 ◽

pp. 50-54

Author(s):

Gregorius Tanamas ◽

Jasmine Iskandar ◽

Tofan W Utami ◽

Tricia D Anggraeni ◽

Kartiwa H Nuryanto

Keyword(s):

Ovarian Cancer ◽

Menopausal Status ◽

Ca 125 ◽

Normal Body Mass Index ◽

Ovarian Cancer Risk ◽

Malignant Case ◽

Risk Of Malignancy ◽

Risk Of Malignancy Index ◽

Pathological Report ◽

Ovarian Masses

Objective: To evaluate Risk of Malignancy Index (RMI) as a triage tool for ovarian cancer in Dr. Cipto Mangunkusumo Hospital. Method: This is a retrospective study conducted from January 2008-December 2012 in patients diagnosed with ovarian mass. Patients admitted for surgery due to ovarian masses were included to this study. RMI 3 score was calculated based on ultrasonography examination in Dr. Cipto Mangunkusumo Hospital, CA-125 test and menopausal status. Patients without final pathological report and incomplete data were excluded from study. Data were analysed using SPSS 20 to evaluate RMI result and final pathlogical report in benign and malignant case. Result: From 882 patients identified with ovarian masses from cancer registry, only 99 patients aged 17-70 y.o were included in this study. Most of the patients were nully-parity (28.3%), non-menopausal women (60.6%), normal body mass index (40.4%), and with stage IIIC ovarian cancer (33.3%). Ultrasonography examination showed that most of patients had solid mass and ascites (19.2%). Meanwhile, CA-125 showed that patients with <35 U/ml were 10.1% and ≥ 35 U/ml were 89.9%. Patients with RMI scores <200 (benign cases) were 19 cases (19.2%) and ≥ 200 (malignant cases) were 80 cases (80.8%). Meanwhile, patients with benign final pathological report were 23 cases (23.2%) and malignant cases were 76 cases (76.8%). There was no statistical difference in RMI between benign and malignant cases based on final pathological report. Conclusion: Our study showed that RMI was not accurate as triage tool for ovarian cancer in our hospital. Further investigation and more patients are needed to confirm this study. Keywords: CA-125, menopausal status, ovarian cancer, risk of malignancy index (RMI), ultrasonography.

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