Abstract
ObjectivesThe purpose of this study is to assess the preoperative evaluation of an adnexal mass using the GI-RADS classification and to verify whether CA-125 measurement can offer any additional benefits to the GI-RADS-based prediction of ovarian tumor malignancy.Material and methodsIn this study, we assessed a total of 215 women with an adnexal tumor using the GI-RADS classification combined with CA-125 measurement. All adnexal masses underwent histological verification.ResultsOf a total of 215 lesions, we classified 2 lesions as GI-RADS 2 (0.9%), 118 lesions as GI-RADS 3 (54.9%), 86 lesions as GI-RADS 4 (40.0%) and 9 lesions as GI-RADS 5 (4.2%). For GI-RADS 4–5 lesions, the sensitivity, specificity, PPV, NPV, ACC and OR were as follows: 94.3, 72.2, 52.6, 97.5, 77.7%, and 43.3 (CI 12.0–146), respectively. The corresponding parameters resulting from combining the GI-RADS classification with the CA-125 marker were as follows: 66.0, 93.8, 77.8, 89.4, 87.0%, and 29.6 (CI 12.6–69.6), respectively, with p < 0.001. For Ca-125 > 30 IU/mL alone, the results were as follows: 70.0, 80.3, 53.8, 89.1, 77.7%, and 9.5 (4.6–19.6), respectively, with p < 0.0001.Additionally, 47.8% of the patients had no symptoms, 36.5% had back pain, 5.2% had an increased abdominal size, 4.3% had menstrual irregularities and 2.6% had constipation. There were 152 benign and 18 malignant cases in the low risk group (GIRADS 1–3 and GIRADS 4 + CA-125 < 30 IU/mL) and 10 benign and 35 malignant tumors in the high-risk group (GIRADS 4 + CA125 > 30 IU/mL and GIRADS 5).ConclusionsGI-RADS classification had good performance in discriminating ovarian tumors. The additional measurement of CA-125 improves the system specificity, PPV and ACC for preoperative adnexal tumor assessment.
Highlights
Ovarian cancer is the most lethal cancer among gynecological malignancies
It has been demonstrated that the survival of ovarian cancer patients is better when treatment is provided at specialized centers by gynecologists with expertise in gynecologic oncology [4]
In the 215 tumors, 2 lesions were classified as Gynecology imaging reporting and data system (GI-RADS) 2 (0.9%), lesions were GI-RADS 3 (54.9%), 86 lesions were
Summary
Ovarian cancer is the most lethal cancer among gynecological malignancies. In Poland, ovarian cancer is the second most frequently diagnosed malignancy of the female. Clinical Unit of Obstetrics, Women’s Disease and Gynecological Oncology, sw. Jozefa 53/59, United District Hospital, Collegium Medicum University of Nicolaus Copernicus in Toruń, Torun, Poland. Nearly 70% of patients with ovarian cancer are diagnosed at an advanced stage, while the 5-year survival rate for patients with ovarian cancer may be as high as. It has been demonstrated that the survival of ovarian cancer patients is better when treatment is provided at specialized centers by gynecologists with expertise in gynecologic oncology [4]
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