Screening for Ovarian Malignancy

NCT06348784 | Completed DMC

• 1 other identifier: 11
• Study Type: observational
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Ovarian cancer is the second most common gynecologic malignancy. In 2008, it was the seventh leading cause of cancer deaths in women worldwide. Estimating the risk of malignancy is essential in the management of adnexal masses and several mathematical models and scoring systems have been developed to be used for discrimination between benign and malignant adnexal masses. Knowledge of the specific type of adnexal pathology before surgery is likely to improve patient triage with high accuracy, and it also makes it possible to optimize treatment. The correct identification of stage I cancer is particularly important

Conditions

Early Detection of Ovarian Cancer

Outcome Measures

Primary Outcomes (1)

• Sensitivity, specificity, positive predictive, and negative predictive value of Assessment of Different NEoplasias in the adneXa model for differentiating between benign and malignant ovarian tumors

  The diagnostic performance of the ADNEX model for differentiating between benign and malignant ovarian tumors was assessed at a threshold of 10%. The diagnostic performance was expressed as Area Under Receiver Operating Characteristic Curve (AUC)

  within 120 days from the scheduled surgery date

Interventions

Assesment of Different NEoplasias in the adenexa model DIAGNOSTIC_TEST

The ADNEX model includes nine parameters; Age, CA-125 level, Oncology center (yes/no), and 6 ultrasound features which are maximal diameter of the lesion, maximal diameter of the largest solid part, more than 10 locules (yes/no), number of papillary projections (0/1/2/3/more than 3), acoustic shadow, and ascites

Risk of malignancy index DIAGNOSTIC_TEST

The RMI was measured as follows; Menopausal status (score is 3 as all patients were postmenopausal X Ultrasound score is based on assessment of 5 features and with the presence of one feature, the score is 1 while if more than one feature is present, the score is 3; the five ultrasound features are the presence of solid components, multilocularity, bilaterality, ascites, and metastases X CA - 125 level

Histopathologic examination DIAGNOSTIC_TEST

Histopathologic examination of all excised specimens was done as this is the gold standard test for detecting ovarian malignancy

Eligibility Criteria

• Age: 40 Years+
• Sex: female
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study participants were 50 postmenopausal patients who presented to the general gynecology or gynecological oncology outpatient clinic with adnexal mass.

You may qualify if:

• All the included patients were postmenopausal; postmenopausal status was defined as having ≥ 1 year of amenorrhea without using any contraceptive method in women ≥ 45 years while for women \< 45 years, two consecutive FSH samples one 1month apart with levels ≥ 30 IU/L were required to confirm menopause

You may not qualify if:

• Accidental discovery of ovarian mass during surgery for other reasons
• Patients with known ovarian cancer who were scheduled for interval debulking after neoadjuvant chemotherapy

Sponsors & Collaborators

• Ain Shams Maternity Hospital: lead

Study Sites (1)

AinShams university maternity hospital

Cairo, Egypt

Location

Related Publications (16)

• Nash Z, Menon U. Ovarian cancer screening: Current status and future directions. Best Pract Res Clin Obstet Gynaecol. 2020 May;65:32-45. doi: 10.1016/j.bpobgyn.2020.02.010. Epub 2020 Mar 3.

  PMID: 32273169 BACKGROUND

• Nohuz E, De Simone L, Chene G. Reliability of IOTA score and ADNEX model in the screening of ovarian malignancy in postmenopausal women. J Gynecol Obstet Hum Reprod. 2019 Feb;48(2):103-107. doi: 10.1016/j.jogoh.2018.04.012. Epub 2018 Apr 28.

  PMID: 29709594 BACKGROUND

• Ali MN, Habib D, Hassanien AI, Abbas AM. Comparison of the four malignancy risk indices in the discrimination of malignant ovarian masses: A cross-sectional study. J Gynecol Obstet Hum Reprod. 2021 May;50(5):101986. doi: 10.1016/j.jogoh.2020.101986. Epub 2020 Nov 13.

  PMID: 33197624 BACKGROUND

• Barrenada L, Ledger A, Dhiman P, Collins G, Wynants L, Verbakel JY, Timmerman D, Valentin L, Van Calster B. ADNEX risk prediction model for diagnosis of ovarian cancer: systematic review and meta-analysis of external validation studies. BMJ Med. 2024 Feb 17;3(1):e000817. doi: 10.1136/bmjmed-2023-000817. eCollection 2024.

  PMID: 38375077 BACKGROUND

• Wang R, Yang Z. Evaluating the risk of malignancy in adnexal masses: validation of O-RADS and comparison with ADNEX model, SA, and RMI. Ginekol Pol. 2023;94(10):799-806. doi: 10.5603/GP.a2023.0019. Epub 2023 Mar 17.

  PMID: 36929789 BACKGROUND

• Munro MG, Critchley HOD, Fraser IS; FIGO Menstrual Disorders Committee. The two FIGO systems for normal and abnormal uterine bleeding symptoms and classification of causes of abnormal uterine bleeding in the reproductive years: 2018 revisions. Int J Gynaecol Obstet. 2018 Dec;143(3):393-408. doi: 10.1002/ijgo.12666. Epub 2018 Oct 10.

  PMID: 30198563 BACKGROUND

• Ali AT, Al-Ani O, Al-Ani F. Epidemiology and risk factors for ovarian cancer. Prz Menopauzalny. 2023 Jun;22(2):93-104. doi: 10.5114/pm.2023.128661. Epub 2023 Jun 14.

  PMID: 37674925 BACKGROUND

• Huwidi A, Abobrege A, Assidi M, Buhmeida A, Ermiah E. Diagnostic value of risk of malignancy index in the clinical evaluation of ovarian mass. Mol Clin Oncol. 2022 May 30;17(1):118. doi: 10.3892/mco.2022.2551. eCollection 2022 Jul.

  PMID: 35747594 BACKGROUND

• Zhang S, Yu S, Hou W, Li X, Ning C, Wu Y, Zhang F, Jiao YF, Lee LTO, Sun L. Diagnostic extended usefulness of RMI: comparison of four risk of malignancy index in preoperative differentiation of borderline ovarian tumors and benign ovarian tumors. J Ovarian Res. 2019 Sep 16;12(1):87. doi: 10.1186/s13048-019-0568-3.

  PMID: 31526390 BACKGROUND

• Yang S, Tang J, Rong Y, Wang M, Long J, Chen C, Wang C. Performance of the IOTA ADNEX model combined with HE4 for identifying early-stage ovarian cancer. Front Oncol. 2022 Sep 16;12:949766. doi: 10.3389/fonc.2022.949766. eCollection 2022.

  PMID: 36185223 BACKGROUND

• Lam Huong L, Thi Phuong Dung N, Hoang Lam V, Tran Thao Nguyen N, Minh Tam L, Vu Quoc Huy N. The Optimal Cut-Off Point of the ADNEX Model for the Prediction of the Ovarian Cancer Risk. Asian Pac J Cancer Prev. 2022 Aug 1;23(8):2713-2718. doi: 10.31557/APJCP.2022.23.8.2713.

  PMID: 36037125 BACKGROUND

• Alberg AJ, Moorman PG, Crankshaw S, Wang F, Bandera EV, Barnholtz-Sloan JS, Bondy M, Cartmell KB, Cote ML, Ford ME, Funkhouser E, Kelemen LE, Peters ES, Schwartz AG, Sterba KR, Terry P, Wallace K, Schildkraut JM. Socioeconomic Status in Relation to the Risk of Ovarian Cancer in African-American Women: A Population-Based Case-Control Study. Am J Epidemiol. 2016 Aug 15;184(4):274-83. doi: 10.1093/aje/kwv450. Epub 2016 Aug 3.

  PMID: 27492896 BACKGROUND

• Elshami M, Tuffaha A, Yaseen A, Alser M, Al-Slaibi I, Jabr H, Ubaiat S, Khader S, Khraishi R, Jaber I, Abu Arafeh Z, Al-Madhoun S, Alqattaa A, Abd El Hadi A, Barhoush O, Hijazy M, Eleyan T, Alser A, Abu Hziema A, Shatat A, Almakhtoob F, Mohamad B, Farhat W, Abuamra Y, Mousa H, Adawi R, Musallam A, Abu-El-Noor N, Bottcher B. Awareness of ovarian cancer risk and protective factors: A national cross-sectional study from Palestine. PLoS One. 2022 Mar 21;17(3):e0265452. doi: 10.1371/journal.pone.0265452. eCollection 2022.

  PMID: 35312720 BACKGROUND

• Rossing MA, Tang MT, Flagg EW, Weiss LK, Wicklund KG. A case-control study of ovarian cancer in relation to infertility and the use of ovulation-inducing drugs. Am J Epidemiol. 2004 Dec 1;160(11):1070-8. doi: 10.1093/aje/kwh315.

  PMID: 15561986 BACKGROUND

• Yu L, Sun J, Wang Q, Yu W, Wang A, Zhu S, Xu W, Wang X. Ovulation induction drug and ovarian cancer: an updated systematic review and meta-analysis. J Ovarian Res. 2023 Jan 24;16(1):22. doi: 10.1186/s13048-022-01084-z.

  PMID: 36694251 BACKGROUND

• Lycke M, Kristjansdottir B, Sundfeldt K. A multicenter clinical trial validating the performance of HE4, CA125, risk of ovarian malignancy algorithm and risk of malignancy index. Gynecol Oncol. 2018 Oct;151(1):159-165. doi: 10.1016/j.ygyno.2018.08.025. Epub 2018 Aug 24.

  PMID: 30149898 BACKGROUND

Biospecimen

Retention: SAMPLES WITHOUT DNA

Ovarian tumors

Study Officials

• Amr H El-Shalakany, M.D.

  Ain Shams University

  STUDY DIRECTOR

• Kareem M Labib, M.D.

  Ain Shams University

  STUDY CHAIR

• Hassan Morsi, PhD

  Ain Shams University

  STUDY CHAIR

• Mortada Elsayed, M.D.

  Ain Shams University

  STUDY CHAIR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Lecturer of Obstetrics and Gynecology

Study Record Dates

• First Submitted: March 25, 2024
• First Posted: April 5, 2024
• Study Start: January 1, 2022
• Primary Completion: January 1, 2023
• Study Completion: January 1, 2023
• Last Updated: April 5, 2024

Record last verified: 2024-03

Data Sharing

• IPD Sharing: Will not share

Locations

EG (1)