Triage of ovarian masses.
BACKGROUND
Triage of ovarian masses for appropriate management is important in ensuring the best outcome for patients. The Risk of Malignancy Indices (RMI) seem to represent a low cost and effective tool for triage and management of women with ovarian masses.


OBJECTIVE
To review patients with an ovarian mass referred to the Gynaecological Cancer Centre at the Royal Hospital for Women, and to assess the effectiveness of the RMI in differentiating benign from malignant tumours in this group of patients.


METHODS
A retrospective review of the case records of all patients with an ovarian mass referred to our centre from January 2003 to December 2005 was undertaken.


RESULTS
Two hundred and four patients were eligible for RMI calculation. An RMI of < 200 correctly identified 83 of 108 (77%) benign ovarian tumours. An RMI of > 200 correctly identified 11 of 19 (58%) borderline ovarian tumours and 70 of 77 (91%) invasive ovarian tumours. An RMI of > 200 had a sensitivity of 84%, specificity of 77%, positive predictive value of 76% and negative predictive value of 85% in detecting both borderline and invasive ovarian tumours. The false negative rate for invasive tumours was 9%.


CONCLUSIONS
This study showed that using RMI at a cut-off of 200 for referral could have prevented 83 benign cases (41%) from being referred. We propose that the RMI could be utilised as a triage tool for referral of ovarian masses to gynaecological cancer centres.
School of Obstetrics and Gynaecology, University of New South Wales, Sydney, Australia.
Yin Nin
YN
Chia
Donald E
DE
Marsden
Greg
G
Robertson
Neville F
NF
Hacker
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014218:Triage / Q000379:methods*