2022-RA-1354-ESGO A new algorithm may highlight benefits from adding HE4 to CA125 in the preoperative assessment of premenopausal patients with pelvic mass

Introduction/Background Recently, ESGO/ISUOG/IOTA/ESGE Consensus Statement on pre-operative diagnosis of ovarian tumors implied that neither Human epididymis protein 4 (HE4) nor Risk Ovarian Malignancy Algorithm (ROMA) improve the discrimination between benign and malignant masses compared with CA 125 alone. This statement may be reassessed if a novel algorithm, more powerful than ROMA, will developed. Thereby aim this study was to elaborate new predictive based serum CA125&HE4, which performs better ROMA Methodology A HE4, CA125 patient’s age as variables, has been developed using training dataset. algorithm named Cancer Kazan Index (ROCK-I). The validating group consisted 227 consecutively operated premenopausal patients pelvic mass out there were 193 cases diseases, 27 cancers 7 borderline (BOT). Results ROCK-I demonstrated two fold less false positive results ROMA. Thus, in dataset, statistically significant superiority over specificity (92.2% 84.5% respectively, p=0.017). Meanwhile, sensitivity also numerically higher all scenarios (table 1). When scenario ‘benign disease vs joint EOC (all stages) together BOT stage Ic2-III’ used, ROC-AUC ROCK-I, 0.988, 0.946 0.937 respectively (figure difference (p=0.01) while not (p=0.79). Conclusion provides suboptimal prediction, at least, patients. If large independent validation shows similar or even slightly lower it provide basis routine-use HE4 preoperative assessment mass.