Background: The CA-125 tumor marker has limitations when used to distinguish between benign and malignant ovarian masses. We therefore establish likelihood curves of six subgroups of ovarian pathology based on CA-125 and menopausal status. Methods: This cross-sectional study conducted by the International Ovarian Tumor Analysis group involved 3,511 patients presenting with a persistent adnexal mass that underwent surgical intervention. CA-125 distributions for six tumor subgroups (endometriomas and abscesses, other benign tumors, borderline tumors, stage I invasive cancers, stage II-IV invasive cancers, and metastatic tumors) were estimated using kernel density estimation with stratification for menopausal status. Likelihood curves for the tumor subgroups were derived from the distributions. Results: Endometriomas and abscesses were the only benign pathologies with median CA-125 levels above 20 U/mL (43 and 45, respectively). Borderline and invasive stage I tumors had relatively low median CA-125 levels (29 and 81 U/mL, respectively). The CA-125 distributions of stage II-IV invasive cancers and benign tumors other than endometriomas or abscesses were well separated; the distributions of the other subgroups overlapped substantially. This held for premenopausal and postmenopausal patients. Likelihood curves and reference tables comprehensibly show how subgroup likelihoods change with CA-125 and menopausal status. Conclusions and Impact: Our results confirm the limited clinical value of CA-125 for preoperative discrimination between benign and malignant ovarian pathology. We have shown that CA-125 may be used in a different way. By using likelihood reference tables, we believe clinicians will be better able to interpret preoperative serum CA-125 results in patients with adnexal masses

Van Calster, B., Valentin, L., Van Holsbeke, C., Zhang, J., Jurkovic, D., Lissoni, A., et al. (2011). A novel approach to predict the likelihood of specific ovarian tumor pathology based on serum CA-125: a multicenter observational study. CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 20(11), 2420-2428 [10.1158/1055-9965.EPI-11-0422].

A novel approach to predict the likelihood of specific ovarian tumor pathology based on serum CA-125: a multicenter observational study

LISSONI, ANDREA ALBERTO;
2011

Abstract

Background: The CA-125 tumor marker has limitations when used to distinguish between benign and malignant ovarian masses. We therefore establish likelihood curves of six subgroups of ovarian pathology based on CA-125 and menopausal status. Methods: This cross-sectional study conducted by the International Ovarian Tumor Analysis group involved 3,511 patients presenting with a persistent adnexal mass that underwent surgical intervention. CA-125 distributions for six tumor subgroups (endometriomas and abscesses, other benign tumors, borderline tumors, stage I invasive cancers, stage II-IV invasive cancers, and metastatic tumors) were estimated using kernel density estimation with stratification for menopausal status. Likelihood curves for the tumor subgroups were derived from the distributions. Results: Endometriomas and abscesses were the only benign pathologies with median CA-125 levels above 20 U/mL (43 and 45, respectively). Borderline and invasive stage I tumors had relatively low median CA-125 levels (29 and 81 U/mL, respectively). The CA-125 distributions of stage II-IV invasive cancers and benign tumors other than endometriomas or abscesses were well separated; the distributions of the other subgroups overlapped substantially. This held for premenopausal and postmenopausal patients. Likelihood curves and reference tables comprehensibly show how subgroup likelihoods change with CA-125 and menopausal status. Conclusions and Impact: Our results confirm the limited clinical value of CA-125 for preoperative discrimination between benign and malignant ovarian pathology. We have shown that CA-125 may be used in a different way. By using likelihood reference tables, we believe clinicians will be better able to interpret preoperative serum CA-125 results in patients with adnexal masses
Articolo in rivista - Articolo scientifico
malignant adnexal masses; ca 125; iota group; multiple imputation; mathematical-models; cancer;benign; distinguish; validation; diagnosis
English
2011
20
11
2420
2428
reserved
Van Calster, B., Valentin, L., Van Holsbeke, C., Zhang, J., Jurkovic, D., Lissoni, A., et al. (2011). A novel approach to predict the likelihood of specific ovarian tumor pathology based on serum CA-125: a multicenter observational study. CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, 20(11), 2420-2428 [10.1158/1055-9965.EPI-11-0422].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/30054
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