[Preoperative identification of malignancy among women with a pelvic mass. Evaluation of a risk index based on ultrasound findings. CA 125 in serum and menopausal status].
A risk of malignancy index (RMI) based on vaginal ultrasound, the tumour marker CA 125 level in serum, and menopausal status was calculated in 134 consecutive patients with a pelvic mass. 41 patients harboured a malignancy, while in 93 the condition was benign. The specificity according to the presence of a malignancy was 95% using the risk of malignancy index, compared with 78% when ultrasound was used alone, and 78% when CA 125 was used alone. The corresponding sensitivities were 73, 71 and 83% respectively. The majority of patients with a false negative index score had early stage ovarian cancer. Only one of the 21 patients with advanced ovarian cancer had a score below the limit of 200. The use of the risk malignancy index is a convenient method for pre-operative identification of cases of advanced ovarian cancer.