title: Highly improved accuracy of the revised PREoperative sarcoma score (rPRESS) in the decision of performing surgery for patients presenting with a uterine mass.
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.
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Nagai
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Takai
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, Japan.
authors.forename: Taichi
authors.initials: T
authors.lastname: Akahori
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Ishida
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Hanaoka
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Uotani
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Sato
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, Japan.
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Matsunaga
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, Japan.
authors.forename: Kazunori
authors.initials: K
authors.lastname: Baba
authors.affiliation: Department of Obstetrics and Gynecology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Seki
keywords: Laparoscopic surgery; Preoperative diagnosis; Uterine sarcoma