Calculating risk assessment for finding an ovarian malignancy during surgery in postmenopausal women who present with an adnexal mass
Only orderable as part of a profile. For more information see ROMA / Ovarian Malignancy Risk Algorithm.
Calculation
Serum
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Frozen (preferred) | 84 days | |
Refrigerated | 48 hours |
Calculating risk assessment for finding an ovarian malignancy during surgery in postmenopausal women who present with an adnexal mass
Women with ovarian cancer symptoms and adnexal masses present primarily to gynecologists, primary care physicians, or general surgeons. Triage guidelines from the American College of Obstetricians and Gynecologists and the Society of Gynecologic Oncologists recommend referral of women with a pelvic mass at high risk for ovarian cancer to gynecologic oncologists. Specialized treatment improves patient outcomes resulting in fewer complications and better survival rates when compared to patients treated by surgeons less familiar with the management of ovarian cancer.
The risk of ovarian malignancy algorithm (ROMA) incorporates cancer antigen 125 (CA125), human epididymal protein 4 (HE4), and menopausal status to assign women that present with an adnexal mass into a high-risk or low-risk group for finding an ovarian malignancy. ROMA is indicated for women who meet the following criteria: older than age 18, presenting with an adnexal mass for which surgery is planned, and who have not yet been referred to an oncologist. ROMA must be interpreted in conjunction with clinical and radiological assessment.
Only orderable as part of a profile. For more information see ROMA / Ovarian Malignancy Risk Algorithm.
In postmenopausal women, a risk of ovarian malignancy algorithm (ROMA) value of 2.99 or greater indicates a high risk of finding epithelial ovarian cancer, whereas a ROMA value less than 2.99 indicates a low risk of finding epithelial ovarian cancer at surgery.
The use of these cutpoints provides a 75% specificity and sensitivity of 84% in patients with stage I-IV epithelial ovarian cancer.
No significant cautionary statements
1. Dochez V, Caillon H, Vaucel E, Dimet J, Winer N, Ducarme G. Biomarkers and algorithms for diagnosis of ovarian cancer: CA125, HE4, RMI and ROMA, a review. J Ovarian Res. 2019;12(1):28. doi:10.1186/s13048-019-0503-7
2. Moore RG, Jabre-Raughley M, Brown AK, et al. Comparison of a novel multiple marker assay vs the Risk of Malignancy Index for the prediction of epithelial ovarian cancer in patients with a pelvic mass. Am J Obstet Gynecol. 2010;203(3):228.e1-6
3. Karlsen MA, Sandhu N, Hogdall C, et al. Evaluation of HE4, CA125, risk of ovarian malignancy algorithm (ROMA) and risk of malignancy index (RMI) as diagnostic tools of epithelial ovarian cancer in patients with a pelvic mass. Gynecol Oncol. 2012;127(2):379-383
The risk score calculation is performed by the laboratory information system.
Monday through Friday
Not Applicable
Test Id | Test Order Name | Order LOINC Value |
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ROMA2 | Risk Score, if postmenopausal | 69570-0 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
ROMA2 | Risk Score, if postmenopausal | 69570-0 |