90346536 A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer

Jacobs, IJ; Oram, Dh; Fairbanks, Joy M.; Turner, Jonathan E.; Frost, Charles; Grudzinskas, J.G.

doi:10.1016/0378-5122(91)90134-c

Cited by 5 publications

(2 citation statements)

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“…To help clinicians decide on appropriate management, mathematical models to predict malignancy in adnexal masses have been developed on cohorts of patients that underwent surgery. A well‐known model is the risk‐of‐malignancy index (RMI) 5 . The International Ovarian Tumor Analysis (IOTA) group created and validated four models to estimate the risk of malignancy in adnexal masses: logistic regression model 1, logistic regression model 2, simple rules risk model (SRRisks) and Assessment of Different NEoplasias in the adneXa (ADNEX) 6 , 7 , 8 , 9 , 10 .…”

Section: Introductionmentioning

confidence: 99%

Benign descriptors and ADNEX in two‐step strategy to estimate risk of malignancy in ovarian tumors: retrospective validation in IOTA5 multicenter cohort

Landolfo

Bourne

Froyman

et al. 2023

Ultrasound in Obstet & Gyne

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Objective Previous work has suggested that the ultrasound‐based benign simple descriptors (BDs) can reliably exclude malignancy in a large proportion of women presenting with an adnexal mass. This study aimed to validate a modified version of the BDs and to validate a two‐step strategy to estimate the risk of malignancy, in which the modified BDs are followed by the Assessment of Different NEoplasias in the adneXa (ADNEX) model if modified BDs do not apply. Methods This was a retrospective analysis using data from the 2‐year interim analysis of the International Ovarian Tumor Analysis (IOTA) Phase‐5 study, in which consecutive patients with at least one adnexal mass were recruited irrespective of subsequent management (conservative or surgery). The main outcome was classification of tumors as benign or malignant, based on histology or on clinical and ultrasound information during 1 year of follow‐up. Multiple imputation was used when outcome based on follow‐up was uncertain according to predefined criteria. Results A total of 8519 patients were recruited at 36 centers between 2012 and 2015. We excluded patients who were already in follow‐up at recruitment and all patients from 19 centers that did not fulfil our criteria for good‐quality surgical and follow‐up data, leaving 4905 patients across 17 centers for statistical analysis. Overall, 3441 (70%) tumors were benign, 978 (20%) malignant and 486 (10%) uncertain. The modified BDs were applicable in 1798/4905 (37%) tumors, of which 1786 (99.3%) were benign. The two‐step strategy based on ADNEX without CA125 had an area under the receiver‐operating‐characteristics curve (AUC) of 0.94 (95% CI, 0.92–0.96). The risk of malignancy was slightly underestimated, but calibration varied between centers. A sensitivity analysis in which we expanded the definition of uncertain outcome resulted in 1419 (29%) tumors with uncertain outcome and an AUC of the two‐step strategy without CA125 of 0.93 (95% CI, 0.91–0.95). Conclusion A large proportion of adnexal masses can be classified as benign by the modified BDs. For the remaining masses, the ADNEX model can be used to estimate the risk of malignancy. This two‐step strategy is convenient for clinical use. © 2022 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

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Section: Introductionmentioning

confidence: 99%

Benign descriptors and ADNEX in two‐step strategy to estimate risk of malignancy in ovarian tumors: retrospective validation in IOTA5 multicenter cohort

Landolfo

Bourne

Froyman

et al. 2023

Ultrasound in Obstet & Gyne

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“…The Risk of Malignancy Index (RMI) algorithm combines CA125 levels, ultrasound results, and menopausal status [46]; however, despite the proposal of several combinations of the formula [47], the RMI possesses lower sensitivity than transvaginal sonography (TVS) alone [32,48]. For this reason, clinical trials such as the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial evaluated CA125 levels combined with TVS; however, the results failed to provide evidence of improvements in mortality rates or early-stage HGSOC detection rates [30,31,49,50].…”

Section: Introductionmentioning

confidence: 99%

Molecular Management of High-Grade Serous Ovarian Carcinoma

Punzón-Jiménez

Lago

Simón

et al. 2022

IJMS

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High-grade serous ovarian carcinoma (HGSOC) represents the most common form of epithelial ovarian carcinoma. The absence of specific symptoms leads to late-stage diagnosis, making HGSOC one of the gynecological cancers with the worst prognosis. The cellular origin of HGSOC and the role of reproductive hormones, genetic traits (such as alterations in P53 and DNA-repair mechanisms), chromosomal instability, or dysregulation of crucial signaling pathways have been considered when evaluating prognosis and response to therapy in HGSOC patients. However, the detection of HGSOC is still based on traditional methods such as carbohydrate antigen 125 (CA125) detection and ultrasound, and the combined use of these methods has yet to support significant reductions in overall mortality rates. The current paradigm for HGSOC management has moved towards early diagnosis via the non-invasive detection of molecular markers through liquid biopsies. This review presents an integrated view of the relevant cellular and molecular aspects involved in the etiopathogenesis of HGSOC and brings together studies that consider new horizons for the possible early detection of this gynecological cancer.

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An ML-based decision support system for reliable diagnosis of ovarian cancer by leveraging explainable AI

Newaz,

Taharat,

Islam

et al. 2024

Informatics in Medicine Unlocked

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90346536 A risk of malignancy index incorporating CA 125, ultrasound and menopausal status for the accurate preoperative diagnosis of ovarian cancer

Cited by 5 publications

References 0 publications

Benign descriptors and ADNEX in two‐step strategy to estimate risk of malignancy in ovarian tumors: retrospective validation in IOTA5 multicenter cohort

Benign descriptors and ADNEX in two‐step strategy to estimate risk of malignancy in ovarian tumors: retrospective validation in IOTA5 multicenter cohort

Molecular Management of High-Grade Serous Ovarian Carcinoma

An ML-based decision support system for reliable diagnosis of ovarian cancer by leveraging explainable AI

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