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Inclusion of CA-125 does not improve mathematical models developed to distinguish between benign and malignant adnexal tumors

Timmerman, Dirk; Van Calster, Ben; Jurkovic, Davor; Valentin, Lil LU ; Testa, Antonia C.; Bernard, Jean-Pierre; Van Holsbeke, Caroline; Van Huffel, Sabine; Vergote, Ignace and Bourne, Tom (2007) In Journal of Clinical Oncology 25(27). p.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... (More)
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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Journal of Clinical Oncology
volume
25
issue
27
pages
4194 - 4200
publisher
American Society of Clinical Oncology
external identifiers
  • wos:000251073200010
  • scopus:34948874223
ISSN
1527-7755
DOI
10.1200/JCO.2006.09.5943
language
English
LU publication?
yes
id
27055433-350f-4318-b42e-03cb765fb703 (old id 974322)
date added to LUP
2008-01-30 09:25:09
date last changed
2017-07-30 03:41:20
@article{27055433-350f-4318-b42e-03cb765fb703,
  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.},
  author       = {Timmerman, Dirk and Van Calster, Ben and Jurkovic, Davor and Valentin, Lil and Testa, Antonia C. and Bernard, Jean-Pierre and Van Holsbeke, Caroline and Van Huffel, Sabine and Vergote, Ignace and Bourne, Tom},
  issn         = {1527-7755},
  language     = {eng},
  number       = {27},
  pages        = {4194--4200},
  publisher    = {American Society of Clinical Oncology},
  series       = {Journal of Clinical Oncology},
  title        = {Inclusion of CA-125 does not improve mathematical models developed to distinguish between benign and malignant adnexal tumors},
  url          = {http://dx.doi.org/10.1200/JCO.2006.09.5943},
  volume       = {25},
  year         = {2007},
}