Adnexal mass risk assessment: A multivariate index assay for malignancy risk stratification

Zhen Zhang, Rowan G. Bullock, Herbert Fritsche

Research output: Contribution to journalArticlepeer-review


Aims: Adnexal mass risk assessment (AMRA) stratifies patients with adnexal masses, identifying the relatively small number of malignancies from benigns which might take a 'watchful waiting' approach. Methods: AMRA uses seven biomarkers and derived from women with adnexal masses scheduled for surgery. Estimated clinical performance was calculated using fixed prevalence. Results: At 5% prevalence, the high-risk group, 7.9% total, captured 75.9% of invasive malignancies at a positive predictive value of 35.8%. High risk/intermediate risk combined had a sensitivity of 89.7 and 95.6% for pre- and post-menopausal cancers, respectively. The low-risk group, 67.8% total, had an negative predictive value of 99.0%. Conclusion: With highly differentiating risk stratification capability across histological subtypes and stages, AMRA is potentially applicable to patients with adnexal masses to assist deciding whether immediate surgery is recommended.

Original languageEnglish (US)
Pages (from-to)3783-3795
Number of pages13
JournalFuture Oncology
Issue number33
StatePublished - 2019


  • adnexal mass
  • multivariate index assay
  • ovarian cancer
  • watch and wait

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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