Guideline No. 403: Initial Investigation and Management of Adnexal Masses

Salvador, Shannon; Scott, Stephanie; Glanc, Phyllis; Eiriksson, Lua; Jang, Ji-Hyun; Sebastianelli, Alexandra; Dean, Erin

doi:10.1016/j.jogc.2019.08.044

Cited by 28 publications

(23 citation statements)

References 50 publications

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“…They found that pre-operative NLR in combination with CA125 are valid discriminative markers for epithelial ovarian cancer, as increased NLR was observed in malignant disease, but not in benign ovarian tumors. However, in our opinion, the diagnostic criteria of malignancies have been well-established using other parameters; particularly, the ultrasound features of the mass and the presence of high Doppler signals, ascites, and abnormal tumoral markers such as CA125 and HE4 have been validated as diagnostic indexes for ovarian cancer [ 44 , 45 ]. Therefore, the association of NLR with cancer outcomes could be useful in indicating the presence of systemic symptoms that correlate with advanced stages of the disease, but NLR is not necessarily a diagnostic parameter.…”

Section: Discussionmentioning

confidence: 99%

Decrease in Neutrophil-to-Lymphocyte Ratio during Neoadjuvant Chemotherapy as a Predictive and Prognostic Marker in Advanced Ovarian Cancer

Sanna

Tanca²,

Cherchi³

et al. 2021

Diagnostics

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Since chronic inflammation is associated with ovarian cancer growth and progression, some clinical studies have assessed the association between the pre-treatment neutrophil-to-lymphocyte ratio (NLR) and the prognosis of ovarian cancer. The purpose of this study was to assess the dynamic behavior of the NLR during the course of neoadjuvant chemotherapy (NACT) in patients with high grade serous (HGS) advanced epithelial ovarian cancer and assess its correlation with clinical response, progression free survival (PFS) and changes in other inflammatory indexes. We performed a prospective observational study on 161 patients who underwent NACT at the Department of Gynecologic Oncology, ARNAS G. Brotzu, Cagliari, between 2009 and 2019. NLR was evaluated before starting and after three cycles of NACT. Based on response after three cycles of NACT, patients were divided into two groups: responsive and non-responsive. The primary endpoint was to assess the predictive role of NLR by comparing the responsive and non-responsive patients at baseline and after three cycles of NACT. Secondary endpoints were (a) to correlate NLR with other inflammation markers (CRP, fibrinogen, ferritin, IL-6), albumin, and modified Glasgow Prognostic Score (mGPS) with NLR at baseline and after NACT; (b) to assess the association between NLR and PFS. We found that the NLR value at baseline was not associated with response to NACT, while a decrease in NLR after three cycles was correlated with a better response to NACT. Also, values of CRP, IL-6, ferritin, and mGPS after three cycles of NACT (but not at baseline) were significantly associated with clinical response. Moreover, we found that patients with a low NLR value after 3 cycles of NACT, but not at baseline, had a significantly higher PFS than patients with high NLR after 3 cycles of NACT. In conclusion, NLR change during treatment could serve as a predictive marker of response to NACT in patients with HGS advanced ovarian cancer. This allows for the early identification of non-responsive patients who will need treatment remodeling.

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Section: Discussionmentioning

confidence: 99%

Decrease in Neutrophil-to-Lymphocyte Ratio during Neoadjuvant Chemotherapy as a Predictive and Prognostic Marker in Advanced Ovarian Cancer

Sanna

Tanca²,

Cherchi³

et al. 2021

Diagnostics

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“…In benign forms of serous cysts, the external surface is regular, smooth, shiny and rich in blood vessels; the cyst wall is thin, less than 3 mm thick, and sometimes translucent.Its contents are fluid, serous, like rock water or citrine and sometimes viscous [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Incidental discovery of a giant ovarian cystadenoma

Bouali

anas

Eddaoudi

et al. 2022

Annals of Medicine &Amp; Surgery

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“…In case of high values of CA125, assessment of CA125 and then ultrasound is considered the most efficient screening method [14] . The survival rate is related to the stage of the disease at the diagnosis.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Calculated Risk of Malignancy Index as a Predictor of the Nature of Adnexal Masses

Mostafa

Assem

Ibrahim

2022

International Journal of Medical Arts

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Article informationBackground: Adnexal masses are common presentation among gynecological practice. Differentiation of benign than malignant lesions is of utmost importance for treatment plan. The gold standard other than histopathology did not determined yet. The aim of the work: The current work aimed to measure the predictive power of the preoperative risk of malignancy index [RMI] to discriminate between benign and malignant adnexal masses. Patients and Methods: This study included 80 patients, presented with adnexal masses/ovarian cysts. They were managed by surgery, during the period from May 2015 to November 2017. We collected the following data: age, gravidity, menopause status, parity, cancer antigen 125 [CA125] levels and ultrasound results. RMI was calculated according to Tingulstad" model. Postoperatively, histopathology results were documented for every patient and used as the gold standard diagnostic modality to measure predictive power of RMI and CA125. Results: Malignant lesions were documented in 27.5%, while 72.5% were benign. The benign tumors were significantly associated with younger age than malignant lesions [27.88±7.68 versus 41.05±11.81]. The postmenopausal women percentages were significantly higher among malignant than benign ovarian lesions [45.5% vs. 1.7%, respectively, p < 0.001]. All ultrasound parameters of RMI were significantly different in malignant than benign masses. The optimal cutoff points of RMI and CA125 were 90.6 and 20.0 respectively. At such points, RMI had 90.6 sensitivity. However, specificity, positive predictive value, negative predictive values were 68.2%, 75.9%, 51.7% and 86.3%, respectively. Conclusion: RMI represented a significant indicator in preoperative assessment of adnexal mass, and was valuable to refer patients to oncology centers, and recommended for screening purposes.

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Guideline No. 403: Initial Investigation and Management of Adnexal Masses

Cited by 28 publications

References 50 publications

Decrease in Neutrophil-to-Lymphocyte Ratio during Neoadjuvant Chemotherapy as a Predictive and Prognostic Marker in Advanced Ovarian Cancer

Decrease in Neutrophil-to-Lymphocyte Ratio during Neoadjuvant Chemotherapy as a Predictive and Prognostic Marker in Advanced Ovarian Cancer

Incidental discovery of a giant ovarian cystadenoma

Evaluation of the Calculated Risk of Malignancy Index as a Predictor of the Nature of Adnexal Masses

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