Screening for Ovarian Malignancy

March 30, 2024 updated by: Ahmed Mohammed Elmaraghy, Ain Shams Maternity Hospital

Assessment of Different Neoplasias in the Adenxa Model Versus Risk of Malignancy Index as a Tool for Predicting Ovarian Malignancy in Postmenopausal Ovarian Cysts

Ovarian cancer is the second most common gynecologic malignancy. In 2008, it was the seventh leading cause of cancer deaths in women worldwide. Estimating the risk of malignancy is essential in the management of adnexal masses and several mathematical models and scoring systems have been developed to be used for discrimination between benign and malignant adnexal masses. Knowledge of the specific type of adnexal pathology before surgery is likely to improve patient triage with high accuracy, and it also makes it possible to optimize treatment. The correct identification of stage I cancer is particularly important

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Ovarian cancer (OC) is the third most common gynecological malignancy worldwide and carries the highest mortality. OC has an incidence of 11.7 - 12.1 per 100,000 in the USA and Europe, with slightly lower rates of disease in Asia and the Middle East. Most patients (60%) are diagnosed with advanced disease which is associated with significant mortality. The most important factor for survival is the stage at diagnosis and nowadays there isn't a proven effective screening strategy. It is necessary to identify the best tool to detect early-stage disease. To reduce the diagnostic dilemma between benign and malignant ovarian masses, a formula-based scoring system known as the risk of malignancy index (RMI) was introduced in 1990, which was termed RMI 1. RMI is a combined parameter that is simple, specific, and highly sensitive for the evaluation of adnexal masses. It is a product of ultrasound findings (U), the menopausal status (M), and serum CA-125 levels (RMI = U X M XCA-125). The original RMI (RMI-1) was modified in 1996 as (RMI 2) and again in 1999 known as (RMI 3), and the last modification was in 2009 by adding the tumor size (S) to the equation and calling it RMI 4. A systematic review of diagnostic studies concluded that the RMI I was the most effective for women with suspected ovarian malignancy.

Malignant tumors benefit from management in specialized oncology centers, but borderline malignancies, stage I primary invasive tumors, and advanced primary invasive tumors might require different surgical approaches. To optimize patient triage without operating on all masses, diagnostic models can be used to estimate the likelihood of malignancy and hence to plan treatment for patients. The International Ovarian Tumor Analysis Group (IOTA) has developed a multi-tumor prediction model, Assessment of Different NEoplasias in the adneXa (ADNEX) model, which is used to describe in detail the characteristics of adnexal masses. ADNEX model can not only distinguish the probability of benign and malignant AMs, but also distinguish between borderline ovarian tumors, stage I ovarian cancer, stage II-IV ovarian cancer, and secondary metastatic ovarian cancers, which includes three clinical features and six ultrasound features

Study Type

Observational

Enrollment (Actual)

50

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
      • Cairo, Egypt
        • Ainshams University maternity hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

N/A

Sampling Method

Non-Probability Sample

Study Population

The study participants were 50 postmenopausal patients who presented to the general gynecology or gynecological oncology outpatient clinic with adnexal mass.

Description

Inclusion Criteria:

  • All the included patients were postmenopausal; postmenopausal status was defined as having ≥ 1 year of amenorrhea without using any contraceptive method in women ≥ 45 years while for women < 45 years, two consecutive FSH samples one 1month apart with levels ≥ 30 IU/L were required to confirm menopause

Exclusion Criteria:

  • Accidental discovery of ovarian mass during surgery for other reasons
  • Patients with known ovarian cancer who were scheduled for interval debulking after neoadjuvant chemotherapy

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sensitivity, specificity, positive predictive, and negative predictive value of Assessment of Different NEoplasias in the adneXa model for differentiating between benign and malignant ovarian tumors
Time Frame: within 120 days from the scheduled surgery date
The diagnostic performance of the ADNEX model for differentiating between benign and malignant ovarian tumors was assessed at a threshold of 10%. The diagnostic performance was expressed as Area Under Receiver Operating Characteristic Curve (AUC)
within 120 days from the scheduled surgery date

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Ain Shams Maternity Hospital

Investigators

  • Study Director: Amr H El-Shalakany, M.D., Ain Shams University
  • Study Chair: Kareem M Labib, M.D., Ain Shams University
  • Study Chair: Hassan Morsi, PhD, Ain Shams University
  • Study Chair: Mortada Elsayed, M.D., Ain Shams University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2022

Primary Completion (Actual)

January 1, 2023

Study Completion (Actual)

January 1, 2023

Study Registration Dates

First Submitted

March 25, 2024

First Submitted That Met QC Criteria

March 30, 2024

First Posted (Actual)

April 5, 2024

Study Record Updates

Last Update Posted (Actual)

April 5, 2024

Last Update Submitted That Met QC Criteria

March 30, 2024

Last Verified

March 1, 2024

More Information

Terms related to this study

Other Study ID Numbers

  • 11

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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