Abstract

Objective

The prognosis for ovarian cancer patients remains poor. A key to maximizing survival rates is early detection and treatment. This requires an accurate prediction of malignancy. Our study seeks to improve the accuracy of prediction by focusing on early subjective assessment of malignancy. We therefore investigated the assessment of patients themselves in comparison to the assessment of physicians.

Methods

One thousand three hundred and thirty patients participated in a prospective and multicenter study in six hospitals in Berlin. Using univariate analysis and multivariate logistic regression models, we measured the accuracy of the early subjective assessment in comparison to the final histological outcome. Moreover, we investigated factors related to the assessment of patients and physicians.

Results

The patients’ assessment of malignancy is remarkably accurate. With a positive predictive value of 58%, the majority of patients correctly assessed a pelvic mass as malignant. With more information available, physicians achieved only a slightly more accurate prediction of 63%.

Conclusions

For the first time, our study considered subjective factors in the diagnostic process of pelvic masses. This paper demonstrates that the patients’ personal assessment should be taken seriously as it can provide a significant contribution to earlier diagnosis and thus improved therapy and overall prognosis.

中文翻译：

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患者主观评估作为盆腔肿块恶性肿瘤的决定性预测因素：多中心、前瞻性盆腔肿块研究的结果

摘要

客观的

卵巢癌患者的预后仍然很差。最大化生存率的关键是早期发现和治疗。这需要准确预测恶性肿瘤。我们的研究旨在通过关注恶性肿瘤的早期主观评估来提高预测的准确性。因此，我们将患者自身的评估与医生的评估进行了比较。

方法

1333 名患者参加了柏林六家医院的前瞻性和多中心研究。使用单变量分析和多变量逻辑回归模型，我们测量了早期主观评估与最终组织学结果相比的准确性。此外，我们调查了与患者和医生评估相关的因素。

结果

患者对恶性肿瘤的评估非常准确。大多数患者的阳性预测值为 58%，正确地将盆腔肿块评估为恶性。有了更多可用信息，医生仅获得了 63% 的稍微准确的预测。

结论

我们的研究首次考虑了盆腔肿块诊断过程中的主观因素。本文表明，应认真对待患者的个人评估，因为它可以为早期诊断做出重大贡献，从而改善治疗和整体预后。