Prognostic value of volume-based metabolic parameters of 18F-FDG PET/CT in ovarian cancer: a systematic review and meta-analysis.
Review
Overview
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.
