OP03.02: A Score System to Assess the Risk of Ovarian Malignancy at Ultrasound: Predictors and Nomogram‐based Analyses

To determine the impact of predefined anamnestic, clinical and ultrasound (US) variables on the risk of malignancy (ROM) of ovarian masses undergoing surgery. Data of women with adnexal masses were prospectively collected in US specialised centres of three gynecologic oncology units. We retrospectively evaluated how anamnestic, clinical and US characteristics impact on the ROM detected at surgery. Predictors of malignancy were identified using uni- and multivariate analyses. A nomogram assessing the ROM was build. Overall, 1053 patients were included. Mean (SD) age was 51.7 (15.2) years. Malignancy was detected in 458 (43%) cases. Univariate analysis showed that age, menopausal status, familiar history of breast cancer, morphological class of the cyst, cysts' diameter, cysts' content, colour score, presence of solid areas, Ca125 levels, bilateral cysts, crescent sign visible, acoustic shadows correlated with the presence of malignancy at final histology. At multivariate analysis significative variables were: Ca125 levels (OR: 1.01 (95%CI: 1.00, 1.02) per 10-unit increase; p=0.009), bilateral cysts (OR: 2.13 (95%CI:1.23, 3.77); p=0.007), cysts' diameter (OR: 1.06 (95%: 1.02, 1.10) per 1 cm increase; p=<0.001), cysts' content (OR: 0.83 (95%CI: 0.74, 0.92); p=0.001), solid area (OR: 7.14 (95%CI: 3.81, 13.3); p<0.001) and colour score (OR: 4.34 (3.37, 5.64); p=0.001). Additionally, family history positive for breast cancer was associated with an increased ROM (OR: 1.59 (95%CI: 0.92, 2.73); p=0.093). A nomogram was created to assess the risk on the basis of various patients' and US characteristics (C-index: 0.77). Our data highlighted the importance of well know US characteristics in predicting the ROM. Moreover, our model would provide a more precise risk with the inclusion of patients' anamnestic and clinical features. In particular, age and family history suggestive for breast cancer should be considered when we approach an ovarian mass in order to drive therapeutic strategies. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.