Adnexal mass risk assessment: a multivariate index assay for malignancy risk stratification

Adnexal mass risk assessment (AMRA) stratifies patients with adnexal masses, identifying the relatively small number of malignancies from benigns which might take a ‘watchful waiting’ approach. AMRA uses seven biomarkers and derived from women with adnexal masses scheduled for surgery. Estimated cli...

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Bibliographic Details
Published inFuture oncology (London, England) Vol. 15; no. 33; pp. 3783 - 3795
Main Authors Zhang, Zhen, Bullock, Rowan G, Fritsche, Herbert
Format Journal Article
LanguageEnglish
Published England Future Medicine Ltd 01.11.2019
Subjects
Adnexa Uteri - diagnostic imaging
Adnexa Uteri - pathology
adnexal mass
Adolescent
Adult
Age
Aged
Aged, 80 and over
Algorithms
Asymptomatic
Biomarkers
Biomarkers, Tumor - blood
Feasibility Studies
Female
Humans
Middle Aged
Models, Biological
multivariate index assay
Ovarian cancer
Ovarian Neoplasms - blood
Ovarian Neoplasms - epidemiology
Ovarian Neoplasms - pathology
Patients
Population
Predictive Value of Tests
Prevalence
Prospective Studies
Risk assessment
Risk Assessment - methods
Sensitivity and Specificity
Surgery
Ultrasonic imaging
United States - epidemiology
watch and wait
Womens health
Young Adult
United States
United States > US
multivariate index assay
adnexal mass
ovarian cancer
watch and wait
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Summary:Adnexal mass risk assessment (AMRA) stratifies patients with adnexal masses, identifying the relatively small number of malignancies from benigns which might take a ‘watchful waiting’ approach. AMRA uses seven biomarkers and derived from women with adnexal masses scheduled for surgery. Estimated clinical performance was calculated using fixed prevalence. At 5% prevalence, the high-risk group, 7.9% total, captured 75.9% of invasive malignancies at a positive predictive value of 35.8%. High risk/intermediate risk combined had a sensitivity of 89.7 and 95.6% for pre- and post-menopausal cancers, respectively. The low-risk group, 67.8% total, had an negative predictive value of 99.0%. With highly differentiating risk stratification capability across histological subtypes and stages, AMRA is potentially applicable to patients with adnexal masses to assist deciding whether immediate surgery is recommended.
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ISSN:1479-6694
1744-8301
DOI:10.2217/fon-2019-0479