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Comparison of the ADNEX and ROMA risk prediction models for the diagnosis of ovarian cancer: a multicentre external validation in patients who underwent surgery.

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Author information

Affiliations

  • 1. Department of Oncology, Laboratory of Tumour Immunology and Immunotherapy, Leuven Cancer Institute, KU Leuven, Leuven, Belgium.
      Authors
    • Landolfo C 1, 3, 7
    • Ceusters J 1, 3
    • Wouters R 1
    • Vankerckhoven A 1
    • Coosemans A 1
    (5 authors)
  • 2. Department of Obstetrics and Gynecology, Skåne University Hospital, Malmö, Sweden.
      Authors
    • Valentin L 2
    (1 author)
  • 3. Department of Development and Regeneration, KU Leuven, Leuven, Belgium.
      Authors
    • Landolfo C 1, 3, 7
    • Ceusters J 1, 3
    • Froyman W 3, 4
    • Heremans R 3, 4
    • Bourne T 3
    • Timmerman D 3, 4
    • Van Calster B 3
    (7 authors)
  • 4. Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium.
      Authors
    • Froyman W 3, 4
    • Van Gorp T 4
    • Heremans R 3, 4
    • Baert T 4
    • Timmerman D 3, 4
    (5 authors)
  • 5. Department of Pathology, UZ Leuven, Leuven, Belgium.
      Authors
    • Van Rompuy AS 5
    (1 author)
    • Show all (10)

ORCIDs linked to this article

Show all (9)

British Journal of Cancer, 19 Jan 2024, 130(6):934-940
https://doi.org/10.1038/s41416-024-02578-x PMID: 38243011 

Free full text available after 19 Jan 2025

Abstract 

Background

Several diagnostic prediction models to help clinicians discriminate between benign and malignant adnexal masses are available. This study is a head-to-head comparison of the performance of the Assessment of Different NEoplasias in the adneXa (ADNEX) model with that of the Risk of Ovarian Malignancy Algorithm (ROMA).

Methods

This is a retrospective study based on prospectively included consecutive women with an adnexal tumour scheduled for surgery at five oncology centres and one non-oncology centre in four countries between 2015 and 2019. The reference standard was histology. Model performance for ADNEX and ROMA was evaluated regarding discrimination, calibration, and clinical utility.

Results

The primary analysis included 894 patients, of whom 434 (49%) had a malignant tumour. The area under the receiver operating characteristic curve (AUC) was 0.92 (95% CI 0.88-0.95) for ADNEX with CA125, 0.90 (0.84-0.94) for ADNEX without CA125, and 0.85 (0.80-0.89) for ROMA. ROMA, and to a lesser extent ADNEX, underestimated the risk of malignancy. Clinical utility was highest for ADNEX. ROMA had no clinical utility at decision thresholds <27%.

Conclusions

ADNEX had better ability to discriminate between benign and malignant adnexal tumours and higher clinical utility than ROMA.

Clinical trial registration

clinicaltrials.gov NCT01698632 and NCT02847832.

Full text links 

Read article at publisher's site: https://doi.org/10.1038/s41416-024-02578-x

References 

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Funding 

Funders who supported this work.

Fonds Wetenschappelijk Onderzoek (1)

Fonds Wetenschappelijk Onderzoek (Research Foundation Flanders) (1)

Kom Op Tegen Kanker Internal Funds

    Linbury Trust Grant

      National Institute for Health Research (NIHR)

        Vetenskapsrådet (1)

        Vetenskapsrådet (Swedish Research Council) (1)

        the Malmö General Hospital Foundation for fighting against cancer Avtal om läkarutbildning och forskning (ALF)-medel Landstingsfinansierad Regional Forskning