Sangwon Han1, Hyesung Kim2, Yeon Joo Kim3, Chong Hyun Suh4, Sungmin Woo5. 1. 1 Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 2. 2 Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Republic of Korea. 3. 3 Department of Radiation Oncology, Kangwon National University Hospital, Chuncheon, Republic of Korea. 4. 4 Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. 5. 5 Department of Radiology, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea.
Abstract
OBJECTIVE: The purpose of this study is to perform a systematic review and meta-analysis of volume-based 18F-FDG PET/CT parameters regarding the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with uterine cervical cancer. MATERIALS AND METHODS: The PubMed and EMBASE databases were systematically searched until January 19, 2018. We included studies that evaluated pretreatment MTV or TLG as a prognostic factor in uterine cervical cancer with event-free (EFS) and overall survival (OS) as the endpoints. Effect sizes of the prognostic value of MTV and TLG were measured in terms of hazard ratio (HR) and were meta-analytically pooled. Multiple subgroup analyses stratified to clinicopathologic and PET/CT variables were performed to explore heterogeneity. RESULTS: Twelve studies including 660 patients were included. Prognoses were worse in patients with high MTV and TLG, with pooled HRs of 5.89 (95% CI, 3.85-9.01; p < 0.00001) and 5.82 (95% CI, 3.62-9.35; p < 0.00001), respectively, for EFS and 6.62 (95% CI, 3.44-12.73; p < 0.00001) and 7.75 (95% CI, 3.48-17.27; p < 0.00001), respectively, for OS. At multiple subgroups analyses, the prognostic values of MTV and TLG for EFS were consistently significant, with pooled HRs of 5.08-7.30 and 4.80-15.83, respectively. CONCLUSION: Volume-based FDG PET/CT parameters were significant prognostic factors in patients with uterine cervical cancer. In spite of clinical and methodologic differences across the studies, patients with high MTV or TLG had a higher risk of adverse events or death.
OBJECTIVE: The purpose of this study is to perform a systematic review and meta-analysis of volume-based 18F-FDG PET/CT parameters regarding the prognostic value of metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with uterine cervical cancer. MATERIALS AND METHODS: The PubMed and EMBASE databases were systematically searched until January 19, 2018. We included studies that evaluated pretreatment MTV or TLG as a prognostic factor in uterine cervical cancer with event-free (EFS) and overall survival (OS) as the endpoints. Effect sizes of the prognostic value of MTV and TLG were measured in terms of hazard ratio (HR) and were meta-analytically pooled. Multiple subgroup analyses stratified to clinicopathologic and PET/CT variables were performed to explore heterogeneity. RESULTS: Twelve studies including 660 patients were included. Prognoses were worse in patients with high MTV and TLG, with pooled HRs of 5.89 (95% CI, 3.85-9.01; p < 0.00001) and 5.82 (95% CI, 3.62-9.35; p < 0.00001), respectively, for EFS and 6.62 (95% CI, 3.44-12.73; p < 0.00001) and 7.75 (95% CI, 3.48-17.27; p < 0.00001), respectively, for OS. At multiple subgroups analyses, the prognostic values of MTV and TLG for EFS were consistently significant, with pooled HRs of 5.08-7.30 and 4.80-15.83, respectively. CONCLUSION: Volume-based FDG PET/CT parameters were significant prognostic factors in patients with uterine cervical cancer. In spite of clinical and methodologic differences across the studies, patients with high MTV or TLG had a higher risk of adverse events or death.
Entities:
Keywords:
PET; metabolic tumor volume; prognosis; total lesion glycolysis; uterine cervical cancer
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