Elizabeth Lokich1, Marguerite Palisoul1, Nicole Romano1, M Craig Miller2, Katina Robison1, Ashley Stuckey1, Paul DiSilvestro1, Cara Mathews1, C O Granai1, Geralyn Lambert-Messerlian3, Richard G Moore4. 1. Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA. 2. Consulting Statistician, Center for Biomarkers and Emerging Technology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA. 3. Center for Biomarkers and Emerging Technology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA; Department of Pathology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA. 4. Program in Women's Oncology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA; Center for Biomarkers and Emerging Technology, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Alpert Medical School at Brown University, Providence, RI 02905, USA. Electronic address: Richard_Moore@URMC.Rochester.EDU.
Abstract
OBJECTIVE: To evaluate the use of as an aid in the identification of women who can safely undergo conservative, non-surgical management. METHODS: All patients referred to the Program in Women's Oncology for surgery with a pelvic mass are evaluated at a prospective multidisciplinary tumor board (TB) where ROMA and imaging are used for management recommendations. This study evaluated women presented to TB with a pelvic mass between 2009 and 2013 who had either surgical or conservative management. RESULTS: Of the 498 patients assessed, 392 (79%) had benign disease, 22 (4%) had LMP tumors, 28 (6%) had stage I-II epithelial ovarian cancer (EOC), 36 (7%) had stage III-IV EOC and 20 (4%) had non-EOC. Using clinical assessment in conjunction with ROMA, the TB recommended observation in 188 (37.8%) women. All patients diagnosed with an invasive malignancy were recommended for surgery by the TB. In the 315 patients managed surgically, 212 were found to have benign disease and 84 women were diagnosed with an invasive malignancy. The sensitivity for the initial TB recommendations using ROMA in conjunction with clinical judgment for detecting malignancy was 100% with a specificity of 47.7% and a NPV of 100%. When including low malignant potential tumors the sensitivity was 99.1%. For stage I-IV EOC ROMA alone had a sensitivity of 95.3%. CONCLUSIONS: ROMA in conjunction with clinical assessment can safely identify women for conservative management.
OBJECTIVE: To evaluate the use of as an aid in the identification of women who can safely undergo conservative, non-surgical management. METHODS: All patients referred to the Program in Women's Oncology for surgery with a pelvic mass are evaluated at a prospective multidisciplinary tumor board (TB) where ROMA and imaging are used for management recommendations. This study evaluated women presented to TB with a pelvic mass between 2009 and 2013 who had either surgical or conservative management. RESULTS: Of the 498 patients assessed, 392 (79%) had benign disease, 22 (4%) had LMP tumors, 28 (6%) had stage I-II epithelial ovarian cancer (EOC), 36 (7%) had stage III-IV EOC and 20 (4%) had non-EOC. Using clinical assessment in conjunction with ROMA, the TB recommended observation in 188 (37.8%) women. All patients diagnosed with an invasive malignancy were recommended for surgery by the TB. In the 315 patients managed surgically, 212 were found to have benign disease and 84 women were diagnosed with an invasive malignancy. The sensitivity for the initial TB recommendations using ROMA in conjunction with clinical judgment for detecting malignancy was 100% with a specificity of 47.7% and a NPV of 100%. When including low malignant potential tumors the sensitivity was 99.1%. For stage I-IV EOC ROMA alone had a sensitivity of 95.3%. CONCLUSIONS: ROMA in conjunction with clinical assessment can safely identify women for conservative management.
Authors: Brian Nolen; Liudmila Velikokhatnaya; Adele Marrangoni; Koen De Geest; Aleksey Lomakin; Robert C Bast; Anna Lokshin Journal: Gynecol Oncol Date: 2010-03-24 Impact factor: 5.482
Authors: Frederick R Ueland; Christopher P Desimone; Leigh G Seamon; Rachel A Miller; Scott Goodrich; Iwona Podzielinski; Lori Sokoll; Alan Smith; John R van Nagell; Zhen Zhang Journal: Obstet Gynecol Date: 2011-06 Impact factor: 7.661
Authors: Richard G Moore; D Scott McMeekin; Amy K Brown; Paul DiSilvestro; M Craig Miller; W Jeffrey Allard; Walter Gajewski; Robert Kurman; Robert C Bast; Steven J Skates Journal: Gynecol Oncol Date: 2008-10-12 Impact factor: 5.482
Authors: Robert E Bristow; Alan Smith; Zhen Zhang; Daniel W Chan; Gillian Crutcher; Eric T Fung; Donald G Munroe Journal: Gynecol Oncol Date: 2012-11-21 Impact factor: 5.482
Authors: Felix Leung; Marcus Q Bernardini; Marshall D Brown; Yingye Zheng; Rafael Molina; Robert C Bast; Gerard Davis; Stefano Serra; Eleftherios P Diamandis; Vathany Kulasingam Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-07-22 Impact factor: 4.254