Comparison of Preoperative Risk of Malignancy Index with Histopathological Findings in Patients with Ovarian Tumors

Background: Ovarian tumors are a significant health concern for women in Bangladesh, often presenting diagnostic challenges due to late-stage identification and limited access to specialized care. Implementing preoperative tools like the Risk of Malignancy Index (RMI) is critical in improving early detection and guiding clinical decision-making in resource-constrained settings. Aim: The aim of this study was to evaluate the correlation between the preoperative RMI and histopathological findings in patients with ovarian tumors. Materials and Methods: This hospital-based cross-sectional study, conducted from September 2022 to August 2023 at Bangladesh Medical University (BMU), included 102 female patients with ovarian tumors scheduled for surgery. Preoperative assessments involved ultrasound scoring, menopausal status determination, and serum CA-125 measurement, used to calculate the RMI. Histopathological examination served as the gold standard for diagnosis. Data were analyzed using SPSS- 26, with Fisher's Exact Test and RMI calculations performed. Ethical approval and informed consent were obtained. A p-value of <0.002 was considered statistically significant. A purposive sampling technique was used to recruit participants based on predefined inclusion and exclusion criteria. Results: A substantial proportion, specifically 40.2%, of these patients were classified as high-risk preoperatively based on their RMI scores, with 45.1% demonstrating elevated CA-125 levels exceeding 100 IU/ ml. Notably, the analysis revealed a statistically significant association (p=0.002) between the type of ovarian tumor and a documented family history of ovarian or breast cancer. Conclusion: The findings highlight that a significant proportion of patients, often within a younger age group, presented with advanced disease, emphasizing the importance of early detection strategies. The statistically significant association between tumor type and family history underscores the need for thorough familial risk assessment. While RMI can serve as a valuable tool.