Highly improved accuracy of the revised PREoperative sarcoma score (rPRESS) in the decision of performing surgery for patients presenting with a uterine mass.

Tomonori Nagai,Sho Sato,Kazunori Baba,Takahiro Uotani,Shigetaka Matsunaga,Yasushi Takai,Hiroyuki Seki,Taichi Akahori,Hiroaki Ishida,Tatsuya Hanaoka

doi:10.1186/s40064-015-1318-7

Tomonori Nagai, Sho Sato + Show 8 more

Open Access

https://doi.org/10.1186/s40064-015-1318-7

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Abstract

In 2014, we published an article titled “Novel uterine sarcoma preoperative diagnosis score predicts the need for surgery in patients presenting with a uterine mass” on the preoperative diagnosis of uterine sarcoma, in the SpringerPlus (Nagai et al. in SpringerPlus 2014, 3:678. doi:10.1186/2193-1801-3-678). Subsequently, we received several suggestions from readers, which were used to modify the statistical analysis methods and create a more precise preoperative diagnostic scoring system, which we present here as a supplemental report. The subjects were 63 patients who underwent surgical therapy for suspected uterine sarcoma (sarcoma group: 15 patients, benign group: 48 patients). Logistic regression analysis using the exact method was performed considering the subjects’ preoperative age, serum lactate dehydrogenase levels, magnetic resonance imaging findings, and endometrial cytology findings. We then used parameter estimates obtained from this analysis to revise the PREoperative Sarcoma Score (PRESS). The revised PRESS (rPRESS) has a maximum score of 10 points and an optimal cut-off value of 4 points, as derived from a receiver operating characteristic curve. Using this, the accuracy, positive predictive value, and negative predictive value were 93.7, 92.3, and 94.0 %, respectively. The diagnostic precision of the rPRESS is better than that of the original PRESS.

Highlights

Uterine sarcoma is a non-epithelial malignant tumor that occurs in the uterus
We found that the revised PRESS (rPRESS) had a higher accuracy in the preoperative diagnosis of uterine sarcoma
Subjects The subjects were the 63 patients from a previous report titled “Novel uterine sarcoma preoperative diagnosis score predicts the need for surgery in patients presenting with a uterine mass” (Nagai et al 2014)

Summary

Introduction

Uterine sarcoma is a non-epithelial malignant tumor that occurs in the uterus. It is resistant to chemotherapy and radiation therapy. The prognosis is extremely poor, except in cases in which early radical resection is possible (Gadducci et al 2008). As the mass grows from the myometrium, approaching it from outside the body and making a pathological diagnosis from a biopsy can be difficult. The early diagnosis of uterine sarcoma often requires a hysterectomy and a pathological search. Preoperative diagnosis for uterine sarcoma using imaging and hematological findings has not exhibited a high accuracy.

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