Title: Inclusion of CA-125 does not improve mathematical models developed to distinguish between benign and malignant adnexal tumors
Authors: Timmerman, Dirk ×
Van Calster, Ben
Jurkovic, Davor
Valentin, Lil
Testa, Antonia C
Bernard, Jean-Pierre
Van Holsbeke, Caroline
Van Huffel, Sabine
Vergote, Ignace
Bourne, Tom #
Issue Date: 11-Sep-2007
Series Title: Journal of Clinical Oncology vol:25 issue:27 pages:4194-4200
Abstract: PURPOSE: To test the value of serum CA-125 measurements alone or as part of a multimodal strategy to distinguish between malignant and benign ovarian tumors before surgery based on a large prospective multicenter study (International Ovarian Tumor Analysis). PATIENTS AND METHODS: Patients with at least one persistent ovarian mass preoperatively underwent transvaginal ultrasonography using gray scale imaging to assess tumor morphology and color Doppler imaging to obtain indices of blood flow. RESULTS: Data from 809 patients recruited from nine centers were included in the analysis; 567 patients (70%) had benign tumors and 242 (30%) had malignant tumors-of these 152 were primary invasive (62.8%), 52 were borderline malignant (21.5%), and 38 were metastatic (15.7%). A logistic regression model including CA-125 (M2) resulted in an area under the receiver operating characteristic curve (AUC) of 0.934 and did not outperform a published (M1) without serum CA-125 information (AUC, 0.936). Specifically designed new models including CA-125 for premenopausal women (M3) and for postmenopausal women (M4) did not perform significantly better than the model without CA-125 (M1; AUC, 0.891 v AUC, 0.911 and AUC, 0.975 v AUC, 0.949, respectively). In postmenopausal patients, serum CA-125 alone (AUC, 0.920) and the risk of malignancy index (AUC, 0.924) performed very well. Results were very similar when the models were prospectively tested on a group of 345 new patients with adnexal masses of whom 126 had malignant tumors (37%). CONCLUSION: Adding information on CA-125 to clinical information and ultrasound information does not improve discrimination of mathematical models between benign and malignant adnexal masses.
ISSN: 0732-183X
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Basic Research in Gynaecology Section (-)
Gynaecological Imaging Section (-)
ESAT - STADIUS, Stadius Centre for Dynamical Systems, Signal Processing and Data Analytics
Gynaecological Oncology
Screening, Diagnostics and Biomarkers (-)
× corresponding author
# (joint) last author

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