Prognostic Value of Volume-Based Metabolic Parameters of 18F-FDG PET/CT in Uterine Cervical Cancer: A Systematic Review and Meta-Analysis.
Review
Overview
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.
