Which Parameters could be Useful for Predicting Malignancy in Solid Adnexal Masses?

Abstract

Abstract To determine which clinical, biochemical and other sonographic parameters could be useful to predict malignancy in sonographically solid adnexal masses. Methods Clinical (age, menopausal status, complaints and physical examination), biochemical (serum CA-125 levels) and other sonographic features (tumor volume, ascites, bilaterality, blood flow location and velocimetric pattern) from 163 women diagnosed as having a solid adnexal mass on B-mode gray-scale ultrasound were reviewed for this retrospective study. All patients had undergone surgery and mass removal. Definitive histologic diagnosis was available in all cases. All parameters were compared to final histological diagnosis (benign or malignant) in univariate statistical analysis. Then a stepwise forward logistic regression analysis was performed to identify those features that independently predict malignancy. Results A total of 173 masses were analyzed. Patients mean age was 52.4 years (range: 15 to 84 years) 117 masses were malignant and 56 were benign. After univariate analysis all parameters showed statistical differences between benign and malignant tumors. After logistic regression analysis only central blood flow (odd ratio: 64.2, 95% CI: 17.07 to 242.03) and presence of ascites (odd ratio: 32.77, 95% CI: 5.38 to 199.72) were identified as independent predictors of malignancy. The presence of one of these two features correlated to malignancy in 98.6% of cases. The absence of both was found in 82.1% of benign tumors. Conclusions The presence or absence of ascites or central blood flow may be helpful for discriminating benign from malignant solid adnexal masses.