Title: Comparison of CA-125, Ultrasound and Risk of Malignancy Index (RMI) in pre-operative

2500 WordsApr 23, 201910 Pages
Title: Comparison of CA-125, Ultrasound and Risk of Malignancy Index (RMI) in pre-operative diagnosis of Ovarian tumors Authors: Arun Muthuvel , Jaya Vijayaraghavan INTRODUCTION Ovarian cancer is the most deadly gynecological cancer and remains a formidable challenge because 70% of the women are diagnosed only in advanced stage[1]. Every year 2.5 lakh new cases of ovarian malignancy are detected. Ovarian cancer is the third most common cancer in Indian women. Primary cyto-reductive surgery and chemotherapy remains the standard treatment for ovarian malignancy. The best opportunity to treat ovarian cancer occurs at the time of initial laparotomy. Ideally patients with ovarian malignancy should be operated by a gynecologic…show more content…
Among the imaging modalities, a pelvic ultrasound either Trans-vaginal or trans-abdominal is appropriate. Ultrasound or CA-125 when used alone had many limitations. Hence many authors have tried combining these tests together to yield a better diagnostic performance . Risk of Malignancy Index (RMI) for ovarian tumors was tried by several authors. In this study, we compare RMI, CA-125, Menopausal status and simple Ultrasound score in pre-operative evaluation of ovarian tumors. AIM OF THE STUDY To evaluate the diagnostic performance of Risk of Malignancy Index (RMI) and its components like Menopausal status, CA-125 and Ultrasound score in differentiating between benign and borderline or malignant ovarian tumors. To compare the 3 modalities included in RMI scoring with each other. MATERIALS & METHODS This is a prospective study. The clinical data were obtained from consecutive 467 women with pelvic masses scheduled for laparotomy or laparoscopy at the Department of Obstetrics and Gynecology, Sri Ramachandra University, Chennai, India between July 2011 and July 2013. Preoperative serum CA 125 levels, ultrasound findings, and menopausal status were noted. As proposed by Jacobs et al.7 in 1990, the RMI is defined as the multiplied value of the ultrasound score (U), menopausal status (M) and serum CA 125 level: RMI = U × M × CA 125 Ultrasound Scoring In all cases, Ultrasound scoring was
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