ABSTRACT
PURPOSE: The purpose of this study was to evaluate the predictive performance of OncoOVARIAN Dx algorithm, which takes into account tumor markers (beta HCG, CA 19.9, CEA, AFP, CA 125, HE4), general biochemistry and clinical data (age, menopause, comorbidities) in patients scheduled for surgical removal of a suspicious adnexal tumor in comparison with the Risk of Malignancy Algorithm (ROMA) model. METHODS: Consecutive women diagnosed with an adnexal tumor mass and scheduled for surgical intervention at a single tertiary cancer between October 2018 - June 2019 were enrolled. Preoperative values of tumor markers and general biochemistry (ASAT, ALAT, GGT, total bilirubin, creatinine) were determined. Following surgery with adequate surgical staging, a definite pathological diagnosis was made and used as reference. RESULTS: A total of 50 patients were selected, including 20 benign, 5 borderline and 25 malignant epithelial ovarian cancer (EOC) cases on final pathology. Borderline tumors comprised 3 serous and 2 mucinous FIGO stage I cases. Malignant tumors included 17 high grade serous, 4 endometrioid and 4 mucinous types, FIGO stage IA-IIIC. The two models demonstrated very good correlation (Phi 0.78, p<0.001). The sensibility (Se), specificity (Sp), positive predictive value (PPV), negative predictive value (NPV) of OncoOVARIAN Dx versus ROMA model were 76.66% vs. 60%, 95% vs. 100%, 95.83% vs. 100%, 73.07% vs. 62.5%, respectively. In postmenopausal patients higher Se (85.71%), Sp (100%) and PPV (100%) were observed for OncoOVARIAN Dx. CONCLUSIONS: OncoOVARIAN Dx model demonstrated higher Se and NPV compared to ROMA and could be a useful marker in the preoperative management of adnexal masses; however larger studies are warranted to validate and further refine this algorithm.
