Abstract
Background: Screening programme for ovarian malignancy is an international public demand. Ojective: To validate a risk of malignancy index (RMI) incorporating serum CA125, abdominal ultrasound findings and menopausal status for preoperative diagnosis of ovarian malignancy among patient with adnexal mass.Methods: This prospective observational study was conducted on 57 patients having adnexal mass admitted consecutively for surgical exploration in BSMMU from January 2000 to March 2001. S. CA125 assay & abdominal ultrasonography was done within 10 days preoperatively. Ultrasound score (0, 1 & 3) using 5 sonographic features & menopausal score (1 & 3) were calculated. RMI was detected by the formula "RMI = Ultrasound score - Menopausal score - S. CA125 level" Definitive diagnosis was based on histopathological examination.See PDF for the rest of the abstract.
Highlights
In-spite of known benefit of meticulous comprehensive surgical staging and cytoreductive surgery many women do not receive approprrate first line surgery
The risk of malignancy index (RMI) is a simple but novel scoring system introduced by Jacobs & his associates in 1990 uttLizing 3 diagnostic criteria - ultrasound findings, serum CA 125 level and menopausal status of the patient
This study showed that RMI could discriminate 83% of malignant from benign mass
Summary
In-spite of known benefit of meticulous comprehensive surgical staging and cytoreductive surgery many women do not receive approprrate first line surgery. The diagnosis of ovarian malign aficy is often difficult to make pre-operatively and inappropriate & inadequate surgical exploration by junior or inexperienced surgeon at improper centre is not uncofirmon sensitive and specific methods for diagnosis of ovarian malignancy are required which may influence the selection of the institution and the seniority and expertise of surgeon. This would provid e a rational basis for refercal before diagnostic laparotomy.8,e. RMI utilizes currently available non-invasive tests , which can be applicable in clinical practice and would provide rational basis for specialist referral of patient with malignancy prior to surgery .tu
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