Comparison of risk of malignancy indices in the preoperative evaluation of adnexal masses
DOI:
https://doi.org/10.18203/2320-1770.ijrcog20221262Keywords:
Adnexal masses, Risk of Malignancy indices, Ovarian cancerAbstract
Background: An adnexal mass patient is a common cause of hospital admission. The differentiation between malignant and benign cases is an important step in the management of such patients. The risk of malignancy index (RMI) is a simple scoring system depend on ultrasound data, menopausal status and serum concentrations of CA-125 tumor marker and has a great value in differentiation between benign and malignant adnexal masses. 4 different types of risk of malignancy index are created. The objective of the study was to compare the diagnostic performance of the four malignancy risk indices in differentiating benign and malignant ovarian tumors.
Methods: This prospective study was performed on 60 patients with an adnexal mass confirmed on vaginal ultrasound.
Results: There was statistical significance difference between the 4 types of RMI in benign and malignant groups. RMI 1, RMI 2, and RMI 3 had nearly the same area under the ROC curve; however, at the cut-off of>58.41, RMI 3 was more sensitive and less specific than RMI 1 or RMI 2. The RMI 2 was the most specific in predicting malignancy in terms of area under the curve; however, there was no statistically significant difference in performance of RMI 2 and 4 in malignant group.
Conclusions: RMI 1, RMI 2, and RMI 3 had nearly the same area under the ROC curve; however, at the cut-off of >58.41, RMI 3 was more sensitive and less specific than RMI 1 or RMI 2, on the other hand the most specific was RMI 2 more than the other 3 RMIs.
References
Terzić M, Dotlić J, Ladjević IL, Atanacković J, Ladjević N. Evaluation of the risk malignancy index diagnostic value in patients with adnexal masses. Vojnosanit Pregl. 2011;68(7):589-93.
Goff BA, Mandel L., Muntz HG, Melancon CH. Ovarian carcinoma diagnosis. Cancer 2000; 89:2068-75.
Demir RH, Marchand GJ. Adnexal masses suspected to be benign treated with laparoscopy. JSLS. 2012;16(1):71-84.
Smorgick N, Maymon R. Assessment of adnexal masses using ultrasound: a practical review. Int J Womens Health. 2014;6:857-63.
Abbas AM, Zahran KM, Nasr A, Kamel HS. A new scoring model for characterization of adnexal masses based on two-dimensional gray-scale and colour Doppler sonographic features. Facts Views Vis Obgyn. 2014;6(2):68-74.
Aktürk E, Karaca RE, Alanbay I, Dede M, Karaşahin E, Yenen MC, Başer I. Comparison of four malignancy risk indices in the detection of malignant ovarian masses. J Gynecol Oncol. 2011;22(3):177-82.
S. Tingulstad, B. Hagen, F.E. Skjeldestad, M. Onsrud, T. Kiserud, T. Halvorsen, et al. Evaluation of a risk of malignancy index based on serum CA125, ultrasound findings and menopausal status in the pre-operative diagnosis of pelvic masses Br J Obstet Gynaecol. 1996;103:826-31.
Mohaammed A, Ahuja V, Taha M. Validation of the Risk of Malignancy Index in primary evaluation of ovarian masses. Middle East Fertility Society Journal. 2014;19(4):324-8.
Ali MN, Habib D, Hassanien AI, Abbas AM, Makarem MH. Preoperative evaluation of patients with ovarian masses using the risk of malignancy index 4 model. Proceedings in Obstetrics and Gynecology. 2018;8(1):1-9.
Van den Akker PAJ, Zusterzeel PLM, Aalders AL, Snijders MPLM, Samlal RAK, Vollebergh JHA, et al. Use of risk of malignancy index to indicate frozen section analysis in the surgical care of women with ovarian tumors. Int J Gynecol Obstet. 2016;133(3):355-8.
Yamamoto Y, Tsuchida A, Ushiwaka T, Nagai R, Matsumoto M, Komatsu J, et al. Comparison of 4 risk-of-malignancy indexes in the preoperative evaluation of patients with pelvic masses: a prospective study. Clin Ovarian Gynecol Cancer. 2014;7(1-2):8-12.
Park JW, Park JH, Song ES, Lee BI, Lee JH, Kim KW, et al. Four risk of malignancy indices in evaluation of pelvic masses. Korean J Obstet Gynecol. 2012;55(9):636-43.
Manjunath A, Sujatha K, Vani R. Comparison of three risk of malignancy indices in evaluation of pelvic masses. Gynecol Onol. 2001;81(2):225-9.
Terzic M, Dotlic J, Likic I, Bmdusic N, Pilic I, Ladjevic N. Risk of malignancy index validity assessment in premenopausal and postmenopausal women with adnexal tumors. Taiwan J Obstet Gynecol. 2013;52(2):253-70.
Geomini P, Kruitwagen R, Bremer GL, Cnossen J, Mol BW. The accuracy of risk scores in predicting ovarian malignancy: a systematic review. Obstet Gynecol. 2009;113(2):384-94.
Ertas S, Vural F, Vural F, Tufekci EC, Ertas AC, Kose et al. Predictive Value of Malignancy Risk Indices for Ovarian Masses in Premenopausal and Postmenopausal Women. Asian Pac J Cancer Prev. 2016;17(4):2177-83.
Clarke SE, Grimshaw R, Rittenberg P, Kieser K, Bentley J. Risk of Malignancy Index in the Evaluation of Patients With Adnexal Masses. J Obstet Gynaecol Can. 2009;31(5):440-5.
