Adnexal masses difficult to classify as benign or malignant using subjective assessment of gray‐scale and Doppler ultrasound findings: logistic regression models do not help

Valentin, Lil; Ameye, Lieveke; Savelli, L.; Fruscio, Robert; Leone, F.; Czekierdowski, Artur; Lissoni, Alessandra; Fischerová, D.; Guerriero, S.; Holsbeke, C. Van; Huffel, Sabine Van; Timmerman, Dirk

doi:10.1002/uog.9030

Cited by 83 publications

(89 citation statements)

References 29 publications

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“…For such masses, it is therefore necessary to use methods other than subjective assessment. It is due to these factors that the measurements of the serum CA125, calculation of the RMI, use of logistic regression models based on ultrasound variables [107], and use of ultrasound simple rules [108] were evaluated. However, their results were inferior to subjective assesment of BOTs.…”

Section: Diagnosismentioning

confidence: 99%

“…The IOTA study designated different mathematical models to calculate the individual risk of malignancy and developed simple ultrasound rules to differentiate benign and malignant tumors. Unfortunately, subjective assessment as well as the mathematical models or simple rules do not perform very well in BOT diagnosis [107,108]. Therefore, second stage testing (biomarkers, proteomics, 3D ultrasound) to ascertain the preoperative diagnosis of BOTs is needed.…”

Section: Future Studiesmentioning

confidence: 99%

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Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

et al. 2012

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After completing this course, the reader will be able to:1. Compare the epidemiologic and reproductive risk factors in BOTs with those in ovarian cancers and describe the molecular background of development of BOTs.2. Use the pathological terminology with either original grouping of borderline category or new subclassification of BOTs and assess the major predictor of recurrence and survival.3. Determine an appropriate diagnostic algorithm for patients with symptoms suggesting malignant ovarian tumors that will identify borderline ovarian tumors when present.This article is available for continuing medical education credit at CME.TheOncologist.com. CME CME ABSTRACTBorderline ovarian tumors represent a heterogeneous group of noninvasive tumors of uncertain malignant potential with characteristic histology. They occur in younger women, are present at an early stage, and have a favorable prognosis, but symptomatic recurrence and death may be found as long as 20 years after therapy in some patients. The molecular changes in borderline ovarian tumors indicate linkage of this disease to type I ovarian tumors (lowgrade ovarian carcinomas). The pathological stage of disease and subclassification of extraovarian disease into invasive and noninvasive implants, together with the presence of postoperative macroscopic residual disease, appear to be the major predictor of recurrence and survival. However, it should be emphasized that the most important negative prognostic factor for recurrence is just the use of conservative surgery, but without any impact on patient survival because most recurrent diseases are of the borderline type-easily curable and with an excellent prognosis. Borderline tumors are difficult masses to correctly preoperatively diagnose using imaging methods because their macroscopic features may overlap with invasive and benign ovarian tumors. Over the past several decades, surgical therapy has shifted from a radical approach to more conservative treatment; however, oncologic safety must always be balanced. Follow-up is essential using routine ultrasound imaging, with special attention paid to the remaining ovary in conservatively treated patients. Current literature on this topic leads to a number of controversies that will be discussed thoroughly in this article, with the aim to provide recommendations for the clinical management of these patients. The Oncologist

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Section: Diagnosismentioning

confidence: 99%

Section: Future Studiesmentioning

confidence: 99%

Diagnosis, Treatment, and Follow-Up of Borderline Ovarian Tumors

et al. 2012

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“…Despite the high rates of accuracy in differentiating the benign from malignant lesions, there remain approximately 7 % of ovarian masses that cannot be characterized (Valentin et al 2011 ). Benign lesions outnumber malignancies.…”

Section: Ovarian Lesionsmentioning

confidence: 99%

Obstetrics and Gynecology

Ong

Thia

2014

Pitfalls in Diagnostic Radiology

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“…To be able to offer women with ovarian masses optimal treatment, one needs to know whether the mass is likely to be benign or malignant. If surgery is required, the method of surgery will depend on the benign or malignant nature of the mass [2]. Most benign cysts can be treated with minimally invasive surgery in a general gynecology unit [3], whereas patients with a malignant tumor need to undergo extensive staging procedures and laparotomy in a specialized unit [4].…”

mentioning

confidence: 99%

“…One of the best methods for discriminating between benign and malignant ovarian masses is the subjective assessment (i.e., a subjective evaluation of gray-scale and Doppler US findings by an experienced examiner; also called the pattern recognition approach) [2,[8][9][10]. With the use of this method, high sensitivity (88-100%) and specificity (62-98%) have been reported in determining malignant adnexal masses [1,2,8].…”

mentioning

confidence: 99%