Pre-Operative Evaluation of Ovarian Tumors by Risk of Malignancy Index, CA125 and Ultrasound

Arun-Muthuvel, Veluswamy; Vijayaraghavan, Jaya

doi:10.7314/apjcp.2014.15.6.2929

Cited by 26 publications

(21 citation statements)

References 18 publications

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“…In our study we found sensitivity 73.5%, specificity 97.1%, PPV 95.3% and NPV 82% by using RMI of more than 200. In the literature different values were defined for RMI and our results confirmed these studies (Jacobs et al, 1990;Davies et al, 1993;Tingulstad et al, 1999;Manjunath et al, 2001;Anderson et al, 2003;Ma et al, 2003;Obeidat et al, 2004;Yamamoto et al, 2009;Van der Akker et al, 2010;Ashrafgangooei et al, 2011;Van Gorp et al, 2012;Sayasneh et al, 2013;Terzic et al, 2013;Arun-Muthuvel et al, 2014).…”

Section: Discussionsupporting

confidence: 87%

“…Ovarian malignancy a common cause of adnexal mass is the most common second gynecological malignancy and the most lethal gynecologic cancer (Wanapirak et al, 2006;Arun-Muthuvel et al, 2014). In preoperative assessment prediction of the benign or malignant character of an adnexal mass is important and an accurate diagnosis is required for choosing appropriate management method.…”

Section: Introductionmentioning

confidence: 99%

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Role of a Risk of Malignancy Index in Clinical Approaches to Adnexal Masses

Simsek¹,

Tokmak²,

Özgü³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Objective: The aim of this study was to evaluate predictive role of risk of malignancy index in discriminating between benign and malignant adnexal masses preoperatively. Methods: This retrospective study was conducted with a total of 569 patients with adnexal masses/ovarian cysts managed surgically at our clinic between January 2006 and January 2012. Obtained data from patient files were age, gravidity, parity, menopause status, ultrasound findings and CA125 levels. For all patients ultrasound scans were performed. For the assessment of risk of malignancy index (RMI) Jacobs' model was used. Histopathologic results of all patients were recorded postoperatively. Malignancy status of the surgically removed adnexal mass was the gold standard. Results: Of the total masses, 245 (43.1%) were malignant, 316 (55.5%) were benign and 8 (1.4%) were borderline. The mean age of benign cases was lower than malign cases (35.2±10.9 versus 50.8±13.4, p<0.001). Four hundred and five of them (71.2%) were in premenopausal period. Malignant tumors were more frequent in postmenopausal women (81% versus 29%, p<0.001). All ultrasound parameters of RMI were statistically significantly favorable for malignant masses. In our study ROC curve analysis for RMI provided maximum Youden index at level of 163.85. When we based on cutoff level for RMI as 163.85 sensitivity, specificity , PPV, NPV was calculated 74.7%, 96.2%, 94% and 82.6%, respectively. Conclusions: RMI was found to be a significant marker in preoperative evaluation and management of patients with an adnexal mass, and was useful for referring patients to tertiary care centers. Although utilization of RMI provides increased diagnostic accuracy in preoperative evaluation of patient with an adnexal mass, new diagnostic tools with higher sensitivity and specificity are needed to discriminate ovarian cancer from benign masses.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Role of a Risk of Malignancy Index in Clinical Approaches to Adnexal Masses

Simsek¹,

Tokmak²,

Özgü³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…In the present study, 4 malignant ovarian masses (80.0%) were in the age group above 45 years, while only 1 case (20%) was in age group less than 30 years. Our findings were similar to studies conducted by Jung Woo Park et al (8) and Veluswamy Arun Muthuvel et al (9) , wherein age group less than 45 years constituted the largest group and rate of malignant ovarian masses were highest in age group above 45 years. In the present study, youngest patient was 12 years old and oldest patient was 70 years old.…”

Section: Agesupporting

confidence: 92%

Risk of Malignancy Index 2 in Preoperative Evaluation of Ovarian Masses and Its Correlation With Histopathology

Thakare¹,

Dube²,

Wankhede³

2016

jemds

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OBJECTIVETo evaluate the accuracy of risk malignancy index 2 in discriminating between benign and malignant ovarian masses preoperatively in gynaecologic practice and its correlation with histopathological report. METHODSThis was a prospective study conducted in a tertiary care hospital from consecutive 90 women with ovarian masses scheduled for surgery at Gynaecology Department between November 2013 and October 2015. After thorough history and clinical examination of patients, preoperative ultrasound findings, serum CA-125 levels and menopausal status were noted and RMI2 was calculated. RESULTSIncidence of benign neoplasm was 94.45%, while that of malignant neoplasm was 5.55%. When three parameters were separately compared with RMI2; RMI2 outperformed the others. After application of chi square test (x 2 ), 'p' value was found to be highly significant for RMI2, USG score and CA-125. CONCLUSIONRMI2 is more accurate in discrimination between malignant and benign ovarian masses than CA-125, USG and Menstrual score alone. It can be introduced easily into clinical practice to facilitate the selection of patients appropriate for primary surgery. KEYWORDSRMI2, Ovarian masses, USG score and CA-125. HOW TO CITE THIS ARTICLE:Thakare S, Dube A, Wankhede S. Risk of malignancy index 2 in preoperative evaluation of ovarian masses and its correlation with histopathology.

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“…There is no established screening method for ovarian cancer; thus, 60-70% patients are at stage III or IV at the time of initial diagnosis (Arun-Muthuvel and Jaya, 2014). Currently the standard-of-care therapy for ovarian cancer is debulking surgery to minimize residual disease, followed by intravenous chemotherapy (IV CT) with a combination of a platinum analogue and paclitaxel (Chumworathayi, 2013;Koo et al, 2014;Suprasert et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Intra-Peritoneal Cisplatin Combined with Intravenous Paclitaxel in Optimally Debulked Stage 3 Ovarian Cancer Patients: An Izmir Oncology Group Study

Ünal

Yılmaz²,

Yavuzşen³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The advantage of intra-peritoneal (IP) chemotherapy (CT) in the initial management of ovarian cancer after cytoreductive surgery is well known. The feasibility and toxicity of a treatment regimen with an IP + intravenous CT (IPIVCT) for optimally debulked stage III ovarian cancer were here evaluated retrospectively. Materials and Methods: A total of 30 patients were treated in our institution between October 2006 and February 2011. Patients received IV paclitaxel 175 mg/m 2 over 3 hours followed by IP cisplatin 75 mg/m 2 on day 1; they also received IP paclitaxel 60 mg/m 2 on day 8. They were also scheduled to receive 6 courses of CT every 21 days. Results: The median age of the patients was 55 years (35-77), and the majority had papillary serous ovarian cancer (63.3%). The patients completed a total of 146 cycles of IPIVCT. Twenty-eight were able to receive at least three cycles of IPIVCT and 18 (60%) completed the scheduled 6 cycles. Two patients discontinued the IPIVCT because of toxicity of chemotherapy agents and 6 had to stop treatment due to intolerable abdominal pain during IP drug administration, obstruction and impaired access. Grade 3/4 toxicities included neutropenia (6 patients; 20%), anemia (2 patients; 6.7%) and nausea-vomiting (2 patients; 6.7%). Doses were delayed in 12 cycles (8%) for neutropenia (n=6), thrombocytopenia (n=3) and elevated creatinine (n=3). Drug doses were not reduced. The median duration of progression-free survival (PFS) was 47.7 months (95%CI, 38.98-56.44) and overall survival (OS) was 51.7 months (95%CI, 44.13-59.29). Two and five-year overall survival rates were 75.6 % and 64.8%, respectively. Conclusions: IPIVCT is feasible and well-tolerated in this setting. Its clinically proven advantages should be taken into consideration and more efforts should be made to administer IPIVCT to suitable patients.

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Pre-Operative Evaluation of Ovarian Tumors by Risk of Malignancy Index, CA125 and Ultrasound

Cited by 26 publications

References 18 publications

Role of a Risk of Malignancy Index in Clinical Approaches to Adnexal Masses

Role of a Risk of Malignancy Index in Clinical Approaches to Adnexal Masses

Risk of Malignancy Index 2 in Preoperative Evaluation of Ovarian Masses and Its Correlation With Histopathology

Intra-Peritoneal Cisplatin Combined with Intravenous Paclitaxel in Optimally Debulked Stage 3 Ovarian Cancer Patients: An Izmir Oncology Group Study

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