Timmerman et al developed 2 logistic regression models for evaluating a woman with an adnexal mass prior to surgery. The simplified model M2 has half the parameters of the more complex model M1. The authors are from multiple university hospitals in Europe representing the International Ovarian Tumor Analysis Group.
Parameters for the first model:
(1) personal history of ovarian cancer
(2) current hormonal therapy
(3) age of the patient in years
(4) maximum diameter of the lesion in mm
(5) presence of pain during the sonographic examination
(6) presence of ascites
(7) presence of blood flow within a solid papillary projection
(8) presence of a purely solid tumor
(9) maximum diameter of the solid component in mm
(10) irregular internal cyst walls
(11) presence of acoustic shadows
(12) color score on ultrasonography for blood flow
|
Parameter |
Finding |
Points |
|
personal history of ovarian cancer |
no |
0 |
|
|
yes |
1 |
|
current hormonal therapy |
no |
0 |
|
|
yes |
1 |
|
age of the patient in years |
age in years |
<age> |
|
maximum diameter of lesion |
diameter in mm |
<diameter> |
|
pain during the examination |
no |
0 |
|
|
yes |
1 |
|
ascites |
no |
0 |
|
|
yes |
1 |
|
blood flow within a papillary projection |
no |
0 |
|
|
yes |
1 |
|
presence of purely solid tumor |
no |
0 |
|
|
yes |
1 |
|
maximal diameter of the solid component in mm |
diameter <= 50 mm |
<diameter> |
|
|
diameter > 50 mm |
50 |
|
irregular internal cyst walls |
no |
0 |
|
|
yes |
1 |
|
presence of acoustic shadows |
no |
0 |
|
|
yes |
1 |
|
color score for blood flow |
no flow |
1 |
|
|
minimal flow |
2 |
|
|
moderate flow |
3 |
|
|
very strong flow |
4 |
where:
• Factors reducing the chances of malignancy are: current hormonal therapy, presence of pain during the exam, and the presence of acoustic shadows (page 8797).
• Factors increasing the chances of malignancy are: age, past history of ovarian cancer, maximum diameter, diameter of solid component, presence of ascites, blood flow in a papillary structure, a purely solid lesion, irregular internal cyst walls, and increased color score.
X =
= (1.5985 * (points for personal history of ovarian cancer)) - (0.9983 * (points for current hormone therapy)) + (0.0326 * (points for age)) + 0.00841 * (points for maximum diameter)) - (0.8577 * (points for pain during exam)) + (1.5513 * (points for ascites)) + (1.1737 * (points for blood flow in a papillary projection)) + (0.9281 * (points for purely solid tumor)) + (0.0496 * (points for maximum diameter of solid component)) + (1.1421 * (points for irregular internal cyst walls)) - (2.355 * (points for acoustic shadows)) + (0.4916 * (points for color score)) - 6.7468
probability of malignancy =
= 1 / (1 + EXP((-1) * X))
Performance (Table 7, page 8800):
• The sensitivity is 93% and specificity is 74% at a cutoff of 10%.
• The area under the ROC curve is 0.936
Specialty: Hematology Oncology, Surgery, general, Obstetrics & Gynecology
ICD-10: ,
