Introduction/Background Adnexal mass is one of the leading causes of admission to the gynecology clinics. Distinction and early diagnosis of malignancy are critical points that the surgical procedure (laparotomy/ laparoscopy, incision type, debulking) and experience/ competence of the surgeon play a major role in the prognosis of the patient who has malignancy. Some of existing indexes are too complex to be used in daily practice, and some contain markers that cannot be done anywhere.Risk of malignancy index(RMI) is practical and simple.
Methodology Between January 2010 and December 2018, 264 patients who had purely adnexal mass and underwent surgery due to presumed malignancy were analyzed. Since 56 patients had data loss, 208 patients were included in the study. RMI-3 and RMI-4 scores were calculated retrospectively.
Results According to the final pathology reports, 52 (25%) of 208 patients were benign, 46 (22%) were borderline and 110 (53%) were malignant. Age and menopausal status were significantly different only in borderline group (table 1). Of malignant tumors, 3 were uterine sarcomas, 8 were metastatic ovarian tumors (all gastrointestinal origin), 99 were primary ovarian cancers. 76 of primary ovarian cancers were epithelial and 23 were nonepithelial. The most common type were respectively serous and endometrioid adenocarcinoma. 76% of primary ovarian cancers were at early stage (stage1–2) and 24% were at advanced stage (stage 3–4). RMI-3 and RMI-4 were both have low specificity, sensitivity and predictive values (table 2). The most unexpected benign tumors were serous cystadenofibroma(%24).
Conclusion For patients with adnexal masses who are not easily accessible to gynecological oncologists, the ability to differentiate benign/ malignant in less specialized hospitals by simple methods will prevent unnecessary referrals and inadequate surgical procedures. This index and our approach are not sufficient.New techniques need to be developed.
Disclosure Nothing to disclose
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