Comparison of three risk of malignancy indices in evaluation of pelvic masses.
OBJECTIVE
The aims of this study were to validate the risk of malignancy index (RMI) incorporating menopausal status, serum CA 125 levels, and ultrasound features for discriminating benign from malignant pelvic masses and to evaluate the performance of the three different risk of malignancy indices (RMI 1, RMI 2, and RMI 3).


METHODS
This is a retrospective study of 152 women admitted at Kasturba Hospital, Manipal, between January 1997 and August 1999 for surgical exploration of pelvic masses. The sensitivity, specificity, and positive predictive value of serum CA 125 levels, ultrasound findings, and menopausal status were taken separately and combined into the RMI 1, RMI 2, and RMI 3 to diagnose ovarian cancer. The risk of malignancy index is the product of menopausal score, ultrasound score, and serum CA 125 levels.


RESULTS
The study confirms that the malignancy risk index is more accurate than the menopausal status, serum CA 125 levels, and ultrasound features separately in diagnosing malignancy. There was no statistically significant difference in the performance of these three different malignancy risk indices in identifying malignancy.


CONCLUSIONS
The risk of malignancy index is able to identify malignant and benign pelvic masses efficiently to optimize therapy. The risk of malignancy index is a simple scoring system which can be used in less specialized gynecology centers. We recommend the use of any of these risk of malignancy indices to facilitate the selection of cases for referral to an oncological unit for adequate staging and optimal debulking.
Manjunath
A P
AP
Kasturba Medical College and Hospital, Manipal, Karnataka State, PIN-576 119, India.
Pratapkumar
Sujatha
K
K
Vani
R
R
D000328:Adult; D018394:CA-125 Antigen / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D010386:Pelvic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000276:immunology / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014463:Ultrasonography
D018394:CA-125 Antigen