The prognostic value of pretreatment [¹⁸F]FDG PET/CT parameters in esophageal cancer: a meta-analysis.

IF 4.7 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING European Radiology Pub Date : 2024-11-21 DOI:10.1007/s00330-024-11207-3

Mingxing Huang, Weichen Wang, Rang Wang, Rong Tian

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Abstract

Objectives: This study aims to evaluate the prognostic implications of pretreatment [¹⁸F]FDG-PET metrics in esophageal cancer patients through a meta-analysis of the existing literature.

Methods: We carefully searched electronic databases, including PubMed and Embase, from inception to April 1, 2024, to identify studies describing the prognostic value of pretreatment PET metrics for advanced esophageal cancer. Clinical endpoints examined were overall survival (OS), recurrence-free survival (RFS)/disease-free survival (DFS), and progression-free survival (PFS). Hazard ratios (HRs) for PFS and OS were taken directly from the original reports.

Results: Forty-seven publications, including 5504 patients, were included in our analysis. OS and PFS were analyzed in 31 and nine studies, respectively, and DFS/RFS was analyzed in 16 studies. The comprehensive pooled analysis revealed significant associations between metabolic parameters derived from positron emission tomography (PET) imaging and clinical outcomes. Expressly, the pooled HR indicated that patients with higher SUVmax were significantly associated with poor PFS (HR: 1.06; 95% CI: 1.01-1.12, p = 0.011) and poor RFS/DFS (HR: 1.09; 95% CI: 1.02-1.18, p = 0.019). Patients with higher SUVmean were significantly associated with poorer OS (HR: 1.07; 95% CI: 1.01-1.14, p = 0.025). High MTV was significantly associated with inferior OS (HR: 1.02; 95% CI: 1.00-1.05, p = 0.049). High TLG was significantly associated with poorer RFS/DFS (HR: 2.02; 95% CI: 1.11-3.68, p = 0.022).

Conclusion: This study unveiled pretreatment FDG-derived parameters as valuable prognostic indicators in assessing esophageal cancer outcomes. Specifically, SUVmax is associated with PFS and RFS/DFS. SUVmean and MTV were correlated with OS, and TLG was only associated with RFS/DFS.

Key points: Question Inconsistent findings on the prognostic value of pretreatment [¹⁸F]FDG PET parameters in esophageal cancer require comprehensive analysis to clarify their role in outcome prediction. Findings Higher pretreatment [¹⁸F]FDG-PET metrics (SUVmax, SUVmean, MTV, TLG) are associated with poor survival outcomes, emphasizing their potential value in enhancing prognostic assessments for esophageal cancer. Clinical relevance This study highlights the prognostic significance of pretreatment [¹⁸F]FDG-PET metrics in esophageal cancer, providing valuable insights for patient outcome prediction and potentially guiding personalized treatment strategies.

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食管癌治疗前[18F]FDG PET/CT 参数的预后价值：一项荟萃分析。

研究目的本研究旨在通过对现有文献进行荟萃分析，评估食管癌患者治疗前[18F]FDG-PET指标对预后的影响：我们仔细检索了从开始到2024年4月1日的电子数据库，包括PubMed和Embase，以确定描述晚期食管癌PET指标治疗前预后价值的研究。研究的临床终点包括总生存期（OS）、无复发生存期（RFS）/无病生存期（DFS）和无进展生存期（PFS）。PFS和OS的危险比（HRs）直接取自原始报告：我们的分析共纳入 47 篇文献，包括 5504 名患者。分别在 31 项和 9 项研究中分析了 OS 和 PFS，在 16 项研究中分析了 DFS/RFS。综合汇总分析显示，正电子发射断层扫描（PET）成像得出的代谢参数与临床预后之间存在显著关联。汇总 HR 显示，SUVmax 较高的患者与 PFS 差（HR：1.06；95% CI：1.01-1.12，p = 0.011）和 RFS/DFS 差（HR：1.09；95% CI：1.02-1.18，p = 0.019）显著相关。SUVmean 较高的患者与较差的 OS 显著相关（HR：1.07；95% CI：1.01-1.14，p = 0.025）。高MTV与较差的OS明显相关（HR：1.02；95% CI：1.00-1.05，p = 0.049）。高TLG与较差的RFS/DFS明显相关（HR：2.02；95% CI：1.11-3.68，p = 0.022）：本研究揭示了治疗前FDG衍生参数是评估食管癌预后的重要指标。具体而言，SUVmax与PFS和RFS/DFS相关。SUVmean 和 MTV 与 OS 相关，而 TLG 仅与 RFS/DFS 相关：问题关于食管癌治疗前[18F]FDG PET参数预后价值的研究结果不一致，需要进行全面分析，以明确其在预后预测中的作用。研究结果较高的治疗前[18F]FDG-PET指标（SUVmax、SUVmean、MTV、TLG）与较差的生存结果相关，强调了它们在加强食管癌预后评估方面的潜在价值。临床意义本研究强调了食管癌治疗前[18F]FDG-PET指标的预后意义，为患者预后预测提供了宝贵的见解，并有可能为个性化治疗策略提供指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Radiology 医学-核医学

CiteScore

11.60

自引率

8.50%

发文量

874

审稿时长

2-4 weeks

期刊介绍： European Radiology (ER) continuously updates scientific knowledge in radiology by publication of strong original articles and state-of-the-art reviews written by leading radiologists. A well balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes ER an indispensable source for current information in this field. This is the Journal of the European Society of Radiology, and the official journal of a number of societies. From 2004-2008 supplements to European Radiology were published under its companion, European Radiology Supplements, ISSN 1613-3749.