Risk of malignancy index 4 for differentiating benign from malignant ovarian tumor

Chandni; Nirbhay Kumar Bind

doi:10.18203/2320-1770.ijrcog20240804

Authors

Chandni Department of Obstetrics and Gynaecology, Vardhman Mahaveer Medical College and Safdarjung Hospital, Delhi, India
Nirbhay Kumar Bind Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20240804

Keywords:

Ovarian cancer, ROMI 4, CA125, RMI, Adnexal mass, Benign, Malignant

Abstract

Background: Approximately 22% of gynaecologic cancers are of ovarian origin, but 47% of all gynaecologic cancer deaths occur in women who have ovarian cancer. Ovarian cancer is usually diagnosed at an advanced stage because most of the symptoms are nonspecific, hence, the difficulty in diagnosis at early stages. In general, there is no effective screening test for ovarian cancer. Aim was to evaluate the ability of risk of malignancy index 4 (ROMI 4) to differentiate benign from malignant ovarian tumors.

Methods: A prospective observational study was conducted in April 2019 to march 2020.

Results: In the present study the ROMI 4 score at cut-off ≥ 450 had sensitivity, specificity, PPV and NPV of 74.3%, 65.3%, 42.6% and 88% respectively for malignant ovarian tumor.

Conclusions: Preoperative ROMI 4 score ≥450 will lead to rational basis for further referral to higher centre or gynaecology oncologist timely for appropriate surgical intervention/ management.

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References

Singhal S, Rajoria L, Mital P, Batar A, Ainani R, Agarwal M, et al. Risk of malignancy index 4 in preoperative evaluation of patients with ovarian tumours. Int J Rep Contracept Obstet and Gynecol. 2018;7(6):2467-71.

Berek JS, Berek and Novak’s Gynecology in chapter 39, ovarian, fallopian tube, and peritoneal cancer, 16th edition, New Delhi, Wolter Kluwer. 2020;1078.

Murthy NS Shalini S, Suman G, Srekantaiah P, Aleyamma M. A changing trends in incidence of ovarian cancer-the Indian scenario. Asian Pac J Cancer Prev. 2009;10(6):1025-30.

Takiar R, Nadayil D, Nandkumar A. Projections of cancer cases in India (2010-2030) by cancer groups, Asian Pacific J Cancer Prev. 2011;21(4);1045-104.

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65(1):5.

Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011. CA Cancer J Clin. 2011;61(4):212-36.

Hoffman BL, Schorge JO, Bradshaw KD, Halvorson LM, Schaffer JI, Corton MM. Williams Gyneacology, United States, in chapter 35, epithelial ovarian cancer. 3rd edition. Mac Graw hill. 2016;762-3.

Ertas S, Vural F, Tufekci EC, Ertas AC, Kose G. Predictive value of malignancy risk indices for ovarian masses in premenopausal and postmenopausal women. Asian Pac J Cancer Prev. 2016;17(4):2177-83.

Karimi-Zarchi M, Mojaver SP, Rouhi M, Hekmatimoghaddam SH, Moghaddam RN, Yazdian-Anari P, et al. Diagnostic value of the risk of malignancy index (RMI) for detection of pelvic malignancies compared with pathology. Electronic Physician. 2015;7(7):1505.

Shintre SA, Survase RM, Patil NA, Sayyed RL. Effectiveness of risk of malignancy index to differentiate benign from malignant ovarian masses-a cross sectional study. Int J of Health Sci Res. 2017;7(5):52-9.

Oram JI, Fairbanks J, Turner J, Frost C, Grudzinskas JG. A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer. Br J Obstet Gynaecol. 1990;97:922.

Jacobs IJ, Skates S, Davies AP, Woolas RP, Jeyerajah A, Weidemann P, et al. Risk of diagnosis of ovarian cancer after raised serum CA 125 concentration: a prospective cohort study. BMJ. 1996;313(7069):1355-8.

Jacobs IJ, Skates SJ, MacDonald N, Menon U, Rosenthal AN, Davies AP, et al. Screening for ovarian cancer: a pilot randomised controlled trial. The Lancet. 1999;353(9160):1207-10.

Yamamoto Y, Yamada R, Oguri H, Maeda N, Fukaya T. Comparison of four malignancy risk indices in the preoperative evaluation of patients with pelvic masses. Eur J Obstet Gynecol Reprod Biol. 2009;144(2):163-7.

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 Obst Gynecol. 2012;55(9):636-43.

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 Cancer Other Gynecol Malig. 2014;7(1-2):8-12.

Campos C, Sarian LO, Jales RM, Hartman C, Araújo KG, Pitta D, et al. Performance of the risk of malignancy index for discriminating malignant tumors in women with adnexal masses. J Med Ultrasound. 2016;35(1):143-52.

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. Proc Obstet Gynecol. 2018;8(1):29.