Prognostic value of baseline metabolic tumor volume and total lesion glycolysis in patients with lymphoma: A meta-analysis

• Published in: PloS one Vol. 14; no. 1; p. e0210224
• Main Authors: Guo, Baoping, Tan, Xiaohong, Ke, Qing, Cen, Hong
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 09.01.2019; Public Library of Science (PLoS)
• Subjects: Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biology and Life Sciences; Cancer therapies; CAT scans; Chemotherapy; Clinical decision making; Confidence intervals; Cyclophosphamide - therapeutic use; Decision making; Doxorubicin - therapeutic use; Female; Fluorodeoxyglucose F18 - therapeutic use; Gene expression; Glycolysis; Glycolysis - genetics; Humans; Lymphoma; Lymphoma, Large B-Cell, Diffuse - diagnostic imaging; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - epidemiology; Lymphoma, Large B-Cell, Diffuse - metabolism; Lymphomas; Male; Medical imaging; Medical prognosis; Medicine and Health Sciences; Meta-analysis; Metabolism; Patients; Physical Sciences; Positron emission tomography; Prognosis; Progression-Free Survival; Proportional Hazards Models; Quality; Radiopharmaceuticals - therapeutic use; Research and Analysis Methods; Studies; Survival; Tomography; Tumor Burden; Tumors; Vincristine - therapeutic use; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0210224

Whether baseline metabolic tumor volume (TMTV) and total lesion glycolysis (TLG) measured by FDG-PET/CT affected prognosis of patients with lymphoma was controversial. We searched PubMed, EMBASE and Cochrane to identify studies assessing the effect of baseline TMTV and TLG on the survival of lymphoma patients. Pooled hazard ratios (HR) for overall survival (OS) and progression-free survival (PFS) were calculated, along with 95% confidence intervals (CI). Twenty-seven eligible studies including 2,729 patients were analysed. Patients with high baseline TMTV showed a worse prognosis with an HR of 3.05 (95% CI 2.55-3.64, p<0.00001) for PFS and an HR of 3.07 (95% CI 2.47-3.82, p<0.00001) for OS. Patients with high baseline TLG also showed a worse prognosis with an HR of 3.44 (95% CI 2.37-5.01, p<0.00001) for PFS and an HR of 3.08 (95% CI 1.84-5.16, p<0.00001) for OS. A high baseline TMTV was significantly associated with worse survival in DLBCL patients treated with R-CHOP (OS, pooled HR = 3.52; PFS, pooled HR = 2.93). A high baseline TLG was significantly associated with worse survival in DLBCL patients treated with R-CHOP (OS, pooled HR = 3.06; PFS, pooled HR = 2.93). The negative effect of high baseline TMTV on PFS was demonstrated in HL (pooled HR = 3.89). A high baseline TMTV was significantly associated with worse survival in ENKL patients (OS, pooled HR = 2.24; PFS, pooled HR = 3.25). A high baseline TLG was significantly associated with worse survival in ENKL patients (OS, pooled HR = 2.58; PFS, pooled HR = 2.99). High baseline TMTV or TLG predict significantly worse PFS and OS in patients with lymphoma. Future studies are warranted to explore whether TMTV or TLG could be integrated into various prognostic models for clinical decision making.