Sangwon Han1,2, Hyesung Kim3, Yeon Joo Kim4, Chong Hyun Suh1,5, Sungmin Woo6,7. 1. Meta-analysis for Imaging studies on Diagnostic test Accuracy and prognosiS (MIDAS) group, Seoul, Republic of Korea. 2. Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 3. Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea. 4. Department of Radiation Oncology, Kangwon National University Hospital, Chuncheon, South Korea. 5. Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 6. Meta-analysis for Imaging studies on Diagnostic test Accuracy and prognosiS (MIDAS) group, Seoul, Republic of Korea. j_crew7@hotmail.com. 7. Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea. j_crew7@hotmail.com.
Abstract
OBJECTIVE: To perform a systematic review and meta-analysis on the prognostic value of 18F-FDG PET-derived volume-based parameters regarding metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with ovarian cancer. METHODS: Pubmed and EMBASE databases were searched up to February 12, 2018 for studies which evaluated MTV or TLG as a prognostic factor in ovarian cancer with progression-free (PFS) and overall survival (OS) as the endpoints. Hazard ratios (HRs) were meta-analytically pooled using the random-effects model. Multiple subgroup analyses based on clinicopathological and PET variables were performed. RESULTS: Eight studies with 473 patients were included. The pooled HRs of MTV and TLG for PFS were 2.50 (95% CI 1.79-3.48; p < 0.00001) and 2.42 (95% CI 1.61-3.65; p < 0.0001), respectively. Regarding OS, the pooled HRs of MTV and TLG were 8.06 (95% CI 4.32-15.05; p < 0.00001) and 7.23 (95% CI 3.38-15.50; p < 0.00001), respectively. Multiple subgroup analyses consistently showed that MTV and TLG were significant prognostic factors for PFS with pooled HRs ranging from 2.35 to 2.58 and from 1.73 to 3.35, respectively. CONCLUSIONS: MTV and TLG from 18F-FDG PET were significant prognostic factors in patients with ovarian cancer. Despite the clinical heterogeneity and difference in methodology between the studies, patients with a high MTV or TLG have a higher risk of disease progression or death.
OBJECTIVE: To perform a systematic review and meta-analysis on the prognostic value of 18F-FDG PET-derived volume-based parameters regarding metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with ovarian cancer. METHODS: Pubmed and EMBASE databases were searched up to February 12, 2018 for studies which evaluated MTV or TLG as a prognostic factor in ovarian cancer with progression-free (PFS) and overall survival (OS) as the endpoints. Hazard ratios (HRs) were meta-analytically pooled using the random-effects model. Multiple subgroup analyses based on clinicopathological and PET variables were performed. RESULTS: Eight studies with 473 patients were included. The pooled HRs of MTV and TLG for PFS were 2.50 (95% CI 1.79-3.48; p < 0.00001) and 2.42 (95% CI 1.61-3.65; p < 0.0001), respectively. Regarding OS, the pooled HRs of MTV and TLG were 8.06 (95% CI 4.32-15.05; p < 0.00001) and 7.23 (95% CI 3.38-15.50; p < 0.00001), respectively. Multiple subgroup analyses consistently showed that MTV and TLG were significant prognostic factors for PFS with pooled HRs ranging from 2.35 to 2.58 and from 1.73 to 3.35, respectively. CONCLUSIONS:MTV and TLG from 18F-FDG PET were significant prognostic factors in patients with ovarian cancer. Despite the clinical heterogeneity and difference in methodology between the studies, patients with a high MTV or TLG have a higher risk of disease progression or death.