Prognostic Implications of the SUVmax of Primary Tumors and Metastatic Lymph Node Measured by 18F-FDG PET in Patients With Uterine Cervical Cancer: A Meta-analysis. (January 2016)

• Record Type: Journal Article
• Authors: Sarker, Azmal; Im, Hyung-Jun; Cheon, Gi Jeong; Chung, Hyun Hoon; Kang, Keon Wook; Chung, June-Key; Kim, E. Edmund; Lee, Dong Soo
• Is Part Of: Clinical nuclear medicine. Volume 41:Number 1(2016)
• Publication Date: 2016-01
• Subjects: FDG PET -- prognosis -- SUVmax -- uterine cervical cancer; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000001049
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Purpose: We conducted a meta-analysis to evaluate the prognostic value of the SUVmax measured in pretreatment primary lesions and metastatic lymph nodes (LNs) on 18 F-FDG PET scans in patients with uterine cervical cancer. Methods: A systematic search of EMBASE and MEDLINE was performed using the keywords "positron emission tomography (PET), " "uterine cervical cancer, " and "prognosis." Event-free survival and overall survival were evaluated as outcomes. The impact of SUVmax on survival was measured by the effect size of the hazard ratio (HR). Results: Fourteen eligible studies including 1150 patients were analyzed. Patients with a high primary SUVmax showed a worse prognosis, with an HR of 2.66 (95% confidence interval [CI], 1.90–3.74; P < 0.00001) for adverse events and an HR of 2.45 (95% CI, 1.74–3.45; P < 0.00001) for death. Patients with high SUVmax in metastatic pelvic LN (PLN) showed a worse prognosis, with an HR of 2.92 (95% CI, 1.94–4.39; P < 0.00001) for adverse events and an HR of 2.66 (95% CI, 1.60–4.43; P = 0.0002) for SUVmax in PLN for death. In addition, high SUVmax in metastatic para-aortic LN was associated with a worse prognosis, with an HR of 4.41 (95% CI, 2.32–8.38; P < 0.00001) for death. Conclusions: Patients with uterine cervical cancer and a high SUVmax primary lesion, PLN, or para-aortic LN are at higher risk of adverse events or death. Abstract : Supplemental digital content is available in the text.