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VOLUME 15 , ISSUE 6 ( November-December, 2023 ) > List of Articles

ORIGINAL RESEARCH

Comparison of Four Risk of Malignancy Indices in Preoperative Evaluation of Patients with Adnexal Masses

Saloni Satyanarayan Zunzunwala, Niranjan Narayanrao Chavan

Keywords : Adnexal mass, CA 125, Risk of malignancy indices

Citation Information : Zunzunwala SS, Chavan NN. Comparison of Four Risk of Malignancy Indices in Preoperative Evaluation of Patients with Adnexal Masses. J South Asian Feder Obs Gynae 2023; 15 (6):658-661.

DOI: 10.5005/jp-journals-10006-2351

License: CC BY-NC 4.0

Published Online: 04-12-2023

Copyright Statement:  Copyright © 2023; The Author(s).


Abstract

Background: The purpose of the study was to evaluate the efficacy of the risk of malignancy index (RMI) in differentiating benign from malignant adnexal lesions. This study also aims to find out the most appropriate index to diagnose the malignancy of the adnexal mass by comparison of four RMIs. Materials and methods: Cross-sectional observational study of 75 women of all ages attending a gynecology outpatient clinic and admitted for exploratory surgery for a pelvic mass in a tertiary care hospital in central India during 2018–2020 has been carried out. Study parameters included the menopausal status, ultrasound features and sensitivity, specificity and positive predictive value of serum CA125 and RMI 1, RMI 2, RMI 3, and RMI 4 were calculated to determine whether the pelvic mass was benign or malignant. Results: All four indices (RMI 1, RMI 2, RMI 3, and RMI 4) were significantly correlated with histopathological findings with a p-value < 0.001. On comparison, no statistically significant difference was observed among the four RMIs to differentiate malignant from benign ovarian masses (p > 0.05). Conclusion: We concluded that the RMI is a simple, noninvasive, easily accessible and applicable, affordable, and inexpensive scoring system for assessing the adnexal masses. The four malignancy risk indices (RMI 1, RMI 2, RMI 3, and RMI 4) can precisely distinguish the benign from malignant pelvic masses.

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  1. Coccia ME, Rizzello F, Romanelli C, et al. Adnexal masses: what is the role of ultrasonographic imaging? Arch Gynecol Obstet 2014;290(2): 843–854. DOI: 10.1007/s00404-014-3327-0.
  2. Fishman DA, Cohen L, Blank SV, et al. The role of ultrasound evaluation in the detection of early-stage epithelial ovarian cancer. Am J Obstet Gynecol 2005;192(3):1214–1221. DOI: 10.1016/j.ajog.2005.01.041.
  3. Guidelines for referral to a gynecologic oncologist: Rationale and benefits. The Society of Gynecologic Oncologists. Gynecol Oncol 2000;78(3 Pt 2):S1–S13. DOI: 10.1006/gyno.2000.5887.
  4. ACOG Practice Bulletin. Management of adnexal masses. Obstet Gynecol 2007;110(1):201–214. DOI: 10.1097/01.AOG.0000263913. 92942.40.
  5. Timmerman D, Ameye L, Fischerova D, et al. Simple ultrasound rules to distinguish between benign and malignant adnexal masses before surgery: prospective validation by IOTA group. BMJ 2010;341(5):1–8. DOI: 10.1136/bmj.c6839.
  6. Sayasneh A, Ekechi C, Ferrara L, et al. The characteristic ultrasound features of specific types of ovarian pathology (review). Int J Oncol 2015;46(2):445–458. DOI: 10.3892/ijo.2014.2764.
  7. Jacobs I, Oram D, Fairbanks J, et al. 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;97:922–929. DOI: 10.1111/j.1471-0528.1990.tb02448.x.
  8. Tingulstad S, Hagen B, Skjeldestad FE, et al. Evaluation of a risk of malignancy index based on serum CA-125, ultrasound findings and menopausal status in the pre-operative diagnosis of pelvic masses. Br J Obstet Gynaecol 1996;103:826–831. DOI: 10.1111/j.1471-0528.1996.tb09882.x.
  9. Tingulstad S, Hagen B, Skjeldestad FE, et al. The risk-of-malignancy index to evaluate potential ovarian cancers in local hospitals. Obstet Gynecol 1999;93:448–452. PMID: 10074998.
  10. Yamamoto Y, Yamada R, Oguri H, et al. Comparison of four malignancy risk indices in the preoperative evaluation of patients with pelvic masses. Eur J Obstet Gynecol Reprod Biol 2009;144(2):163–167. DOI: 10.1016/j.ejogrb.2009.02.048.
  11. Aktürk E, Karaca RE, Alanbay I, et al. Comparison of four malignancy risk indices in the detection of malignant ovarian masses. J Gynecol Oncol 2011;22(3):177–182. DOI: 10.3802/jgo.2011.22.3.177.
  12. Zhang S, Yu S, Hou W, et al. Diagnostic extended usefulness of RMI: Comparison of four risk of malignancy index in preoperative differentiation of borderline ovarian tumors and benign ovarian tumors. J Ovarian Res 2019;12(1):87. DOI: 10.1186/s13048-019- 0568-3.
  13. Andersen ES, Knudsen A, Rix P, et al. Risk of malignancy index in the preoperative evaluation of patients with adnexal masses. Gynecol Oncol 2003;90(1):109–112. DOI: 10.1016/s0090-8258(03)00192-6.
  14. Obeidat BR, Amarin ZO, Latimer JA, et al. Risk of malignancy index in the preoperative evaluation of adnexal masses. Int J Gynaecol Obstet 2004;85(3):255–258. DOI: 10.1016/j.ijgo.2003.10.009.
  15. Ulusoy S, Akbayir O, Numanoglu C, et al. The risk of malignancy index in discrimination of adnexal masses. Int J Gynaecol Obstet 2007;96(3):186–191. DOI: 10.1016/j.ijgo.2006.10.006.
  16. Manjunath AP, Pratap Kumar, Sujatha K, et al. Comparison of three risk of malignancy indices in the evaluation of pelvic masses. Gynecol Oncol 2001;81(2):225–229. DOI: 10.1006/gyno.2001.6122.
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