Abstract 70P
Background
This retrospective study aimed to evaluate the accuracy of the O-RADS MRI risk stratification system for characterising EOTs, especially the BEOTs. More importantly, the efficiency of tumor biomarkers in distinguishing the nature of EOTs and guiding clinical management for each O-RADS MRI risk category was explored in Department.
Methods
54 benign, 104 borderline and 203 malignant EOTs were enrolled and retrospectively assigned risk scores. The diagnostic efficacy of CA125, HE4 and ROMA index in distinguishing EOTs within each risk category was evaluated using ROC curves. Clinical management recommendations were made for EOTs across all risk categories by integrating tumor biomarkers.
Results
No MEOTs were assigned a risk score of 2, while 0.96% BEOTs and 29.63% benign EOTs scored O-RADS MRI 2. Therefore, EOTs assigned a score of 2 are eligible for minimally invasive or conservative, or elective surgery. 66.67% of benign, 50.96% of borderline, and 13.80% of malignant EOTs were assigned a score of 3. Among EOTs with O-RADS MRI 3, 96.43% MEOTs and 98.11% BEOTs had the feature of a low-risk time-intensity curve (TIC), compared to only 16.67% in benign EOTs. CA125 ≥ 60.39 U/ml helped screen MEOTs from EOTs with a low-risk TIC and O-RADS MRI 3 for timely surgical evaluation. Only 3.7% (2/54) benign EOTs were assigned as O-RADS MRI 4/5, while BEOTs and MEOTs were 48.08% and 86.2%, respectively. Overall, EOTs with a score of 4/5 should refer to semi-elective surgery due to the low probability of benign lesions. Specifically, minimally invasive surgery is recommended for EOTs with a ROMA index < 20.14% (premenopausal)/29.9% (postmenopausal), while comprehensive staging or cytoreductive surgery is recommended for the remaining. It is worth mentioning that there was a high proportion of fertility preservation needs and a high possibility of conducting fertility preservation surgery among premenopausal EOT patients assigned as O-RADS MRI 4/5 with a ROMA index < 20.14%.
Conclusions
The O-RADS MRI risk score accurately distinguished between benign EOTs and BEOTs/MEOTs. CA125 and the ROMA index helped further determine EOTs and facilitate clinical management in the O-RADS MRI 3/4/5 categories.
Legal entity responsible for the study
The authors.
Funding
This study was financially supported by 333 project of Jiangsu Province (Xuemei Jia and Juan Xu), Jiangsu Women and Children's Health Care Association Research Project (FXY202320), Jiangsu Maternal and Child Health Research Project (F202106), Nanjing Medical Science and Technique DevelopmentFoundation (ZKX21051), Jiangsu Province Capability Improvement Project through Science, Technology and Education Jiangsu Provincial Medical Key Discipline (ZDXK202211).
Disclosure
All authors have declared no conflicts of interest.