Gynecologic Oncology 2020: Comparison of Various Risk of Malignancy Index (RMI) Scoring Systems for Cancer Risk Assessment among Filipino Women with Ovarian Masses

MuhamadSaiful Anwar Marian

Abstract

Gynecologic disease is any malignant growth that begins in a womens conceptive organs. Infection rising in or near the ovary is actually an arrangement of various malignancies. This collection of malignancies, routinely insinuated as "ovary ailment," Background: To determine the optimal cut-off point of the preoperative risk of malignancy index (RMI) and to characterize the population and determine the association of the following demographic and clinical characteristics with ovarian cancer. Materials and Methods: 172 operated women were assessed retrospectively. RMI of 1, 2, 3 and 4; cut-off values for an effective benign or malignant differentiation together with sensitivity, specificity, negative and positive predictive values were calculated. Results: This cohort study compared the Risk of Malignancy Index (RMI) scoring system (RMI1, RMI2, RMI3 and RMI4). Based on the histological examination of the surgical specimens of 172 patients, 38 (22.09%) had malignant and 134 (77.91%) had benign ovarian masses. Age, body mass index and menopausal status were associated with malignancy. The optimal cut off points of RMI1, RMI2, RMI3 and RMI4 based on ROC curve analysis were as follows: 72.29, 284.49, 254.52 and 284.49 respectively. RMI 2 and RMI 4 have the highest specificity of 85.1% (CI: 77.9% -90.6%), highest positive predictive values of 59.2% (CI: 47.3- 77.7) and highest positive likelihood ratio of 5.11 (CI: 3.28-7.95) while RMI 1 has the highest sensitivity of 86.8% (CI: 0.719-0.956) and highest negative predictive value of 95.3 (CI: 88.7 - 96.9). Conclusions: The RMI scoring systems are recommended to provide an objective assessment of the underlying malignant potential hence can be the test of choice in the preoperative evaluation of the adnexal mass. A Chyke, E Anna, and E Allison. Diagnosis and Management of Ovarian Cancer. American Family Physician, 2016. 93, 11. 2. Department of Health. Ovarian Cancer. Updated in 2017 (as cited from https://www.doh.gov.ph/Health-Advisory/Ovarian-Cancer) 3. Laudico et al. 2015. Philippine cancer facts and estimates. Philippine cancer society- manila cancer registry. 2015 Note: This work is partly presented at the Event on International Conference on Gynecology and Obstetrics, August 12-13, 2019 held at Paris, France

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