Seebacher et al reported a nomogram for predicting ovarian cancer in a patient with an adnexal mass. This can help to identify a patient who may require a more comprehensive evaluation. The authors are the Medical University of Vienna and the Karl Landsteiner Institute for General Gynecology and Experimental Gynecologic Oncology.
Patient selection: adult woman with an adnexal mass
Prevalence of ovarian cancer (including borderline tumors): 27%
Parameters:
(1) plasma fibrinogen in mg/dL
(2) serum CA125 in kU/L
(3) pathological ultrasound (M-criteria present)
(4) menopause
Parameter
Finding
Points
plasma fibrinogen
< 342 mg/dL
0
>= 342 mg/dL
4.9
CA125
< 35 kU/L
0
>= 35kU/L
10
pathological US
no
0
yes
7
menopause
no
0
yes
5.3
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 27.2
value of X =
= (0.258 * (score)) - 4.802
probability of ovarian cancer =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.91.
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