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Re: gyn onc From: Geffrey H. Klein, MD (gklein@icsi.net) Wed Mar 31 09:46:51 1999 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Roberta Speyer: "Live Surgery for Multiple Birth" Previous message: Chambers, Charles E.: "gyn onc" In reply to: Chambers, Charles E.: "gyn onc" At 10:05 AM -0600 on 3/31/99, Chambers, Charles E. wrote: > I think the important concept is appropriate care by the appropriate > physician. Some amount of trust is necessary in the primary physician to use > prudent judgement to make this decision. Certainly, in a stage 3 or 4 > ovarian ca, a gyn onc is invaluable. But at the other side of the argument, > are patients that have self-selected tertiary care, and had a TAH and BSO > for a benign small cyst that could have easily been done laparoscopically. > > BTW, the malignancy index seems interesting. Is it possible someone could > forward the indices used and their calculation?? > ---------------------------- > ---------------------------- > ---------------------------- > > ---------------------------- > Charlie Chambers, MD > Owatonna Clinic-Mayo Health Systems > cchamber@mnic.net > chambers.charles@mayo.edu >From the article: Materials and Methods Serum samples were collected preoperatively in the local hospitals and sent for analysis of CA 125 at the Norwegian Radium Hospital. Automated two-step immunofluorometric assay was performed using the AutoDELFIA analyzer (Wallac Oy, Turku, Finland) with K93 and K101 as solid-phase and europium-labeled antibody, respectively.10 The assay was standardized against the second-generation Abbott IMx CA 125 assay (Abbott Labs, Abbot Park, IL).11 We used this assay in our previous evaluation of the risk-of-malignancy index.8 Control serums with target values of 20 and 63 kU/L gave variation coefficients of 11.3 and 7.6%, during the 2-year sampling and analysis period. Postmenopausal status was defined as more than 1 year of amenorrhoea, or age 50 years or older among women who had hysterectomies. In the risk-of-malignancy index, menopausal status was given a value of three when postmenopausal, and one when premenopausal or perimenopausal.6,7,8 Vaginal ultrasonography (5.0- or 6.5-MHz transducer) was performed by gynecologists at the participating hospitals and supplemented with a transabdominal (3.5-MHz) approach when necessary. To calculate ultrasound scores, multiloculated cysts, solid areas, bilateral lesions, ascites, and evidence of intra-abdominal metastases were recorded and given a value of one when identified. Calculation of the risk-of-malignancy index (RMI = M x U x CA 125) was modified from the original equation6 by combining the ultrasound score of zero or one to give U = 1, whereas for two or more features, U = 3 was used in the equation. -- Geffrey H. Klein, MD geffrey.klein@obgyn.net 2200 Nasa Rd 1 #200 Houston, Texas 77058 (713) 741 2273 ext 2628 Next message: Roberta Speyer: "Live Surgery for Multiple Birth" Previous message: Chambers, Charles E.: "gyn onc" In reply to: Chambers, Charles E.: "gyn onc"

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