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Predictors of Pelvic Malignancy
Title: Pelvic examination, tumor marker level, and gray-scale and Doppler sonography in the prediction of pelvic cancer
Author: L D Roman et al.
Address: Los Angeles, CA
Source: Obstetrics and Gynecology 89: 493-500,1997 (April)
Synopsis: Pelvic examination, CA 125 level, alpha-fetoprotein lactate dehydrogenase and hCG levels, transabdominal or transvaginal gray scale ultrasound and color Doppler sonography were utilized to assess preoperative predictors of malignancy in a prospective study of 226 women scheduled to have a pelvic mass removed. If examination, CA 125 and gray scale ultrasound findings were non-suspicious, 99% of premenopausal women and 100% postmenopausal women had benign masses. If the three indicators mentioned were suspicious, 77% premenopausal and 83% post menopausal women had a pelvic malignancy. Tumor size and ultrasound appearance were the best predictors of pelvic malignancy in premenopausal women and ultrasonographic appearance and CA 125 levels as the best predictors in postmenopausal women.
Comment: Clearly, an accurate preoperative prediction of malignancy is important for selecting the optimal operative approach, incision type and operative procedure. Once again, the importance of ultrasound is emphasized. Also, see the article reviewed on April 2 regarding ultrasound.