Benign descriptors and ADNEX in two‐step strategy to estimate risk of malignancy in ovarian tumors: retrospective validation in IOTA5 multicenter cohort

• DOI: 10.1002/uog.26080
• Publication Date: 2022-09-30T16:44:39Z
• Authors: C. Landolfo; T. Bourne; W. Froyman; B. Van Calster; J. Ceusters; A. C. Testa; L. Wynants; P. Sladkevicius; C. Van Holsbeke; E. Domali; R. Fruscio; E. Epstein; D. Franchi; M. J. Kudla; V. Chiappa; J. L. Alcazar; F. P. G. Leone; F. Buonomo; M. E. Coccia; S. Guerriero; N. Deo; L. Jokubkiene; L. Savelli; D. Fischerova; A. Czekierdowski; J. Kaijser; A. Coosemans; G. Scambia; I. Vergote; D. Timmerman; L. Valentin
• Keywords: Adnexal mass; Ovarian tumor; Interim analysis

ABSTRACT Objective Previous work has suggested that the ultrasound‐based benign simple descriptors (BDs) can reliably exclude malignancy in a large proportion of women presenting with an adnexal mass. This study aimed to validate modified version BDs and two‐step strategy estimate risk malignancy, which are followed by Assessment Different NEoplasias adneXa (ADNEX) model if do not apply. Methods was retrospective analysis using data from 2‐year interim International Ovarian Tumor Analysis (IOTA) Phase‐5 study, consecutive patients at least one mass were recruited irrespective subsequent management (conservative or surgery). The main outcome classification tumors as malignant, based on histology clinical ultrasound information during 1 year follow‐up. Multiple imputation used when follow‐up uncertain according predefined criteria. Results A total 8519 36 centers between 2012 2015. We excluded who already recruitment all 19 did fulfil our criteria for good‐quality surgical data, leaving 4905 across 17 statistical analysis. Overall, 3441 (70%) benign, 978 (20%) malignant 486 (10%) uncertain. applicable 1798/4905 (37%) tumors, 1786 (99.3%) benign. ADNEX without CA125 had area under receiver‐operating‐characteristics curve (AUC) 0.94 (95% CI, 0.92–0.96). slightly underestimated, but calibration varied centers. sensitivity we expanded definition resulted 1419 (29%) AUC 0.93 0.91–0.95). Conclusion masses be classified BDs. For remaining masses, malignancy. is convenient use. © 2022 Authors. Ultrasound Obstetrics & Gynecology published John Wiley Sons Ltd behalf Society Gynecology.