Urban RR, et al. - In women presenting for surgery with an adnexal mass, researchers evaluated the performance of a symptom index (SI) and multivariate biomarker panel in identifying ovarian cancer. They found that, in this patient population, better accuracy was achieved in the evaluation of ovarian cancer with the combination of a patient-reported symptom index and refined biomarker panel. Findings suggested the potential utility of this strategy to provide a personalized approach to addressing the risk of malignancy (ROM) to triage patients with an adnexal mass to appropriate care.

Methods

• In this prospective study, patients seen at a tertiary medical center were included.
• Researchers obtained consent and thereafter asked patients to complete an SI and collected preoperative serum for individual markers (CA 125) and a second-generation FDA-cleared biomarker test (MIA2G).
• They correlated the results for the SI and MIA2G with operative findings and surgical pathology.
• They performed logistic regression modeling to evaluate the interaction of the SI with MIA2G to determine the risk of malignancy (ROM).

Results

• This study included 218 patients, with mean age 53.6 years (range 18–86); 147 patients (67.4%) were postmenopausal.
• Data showed 64 patients (29.4%) had epithelial ovarian cancer or fallopian tube cancer (EOC/FTC) and 17 (7.8%) had borderline ovarian tumors.
• As per findings, 96.1% of patients with EOC/FTC were correctly identified by a positive SI or MIA2G.
• Logistic regression revealed significant associations of both SI and MIA2G score with ROM (p < 0.001).
• In a simulation with disease prevalence set at 5%, a ROM of 1.8% was found in patients with a negative SI and a MIA2G score of 6, while a 10.5% ROM was seen in patients with the same MIA2G and positive SI, nearly a 6-fold higher risk.