Abstract
Purpose The present systematic literature review and meta-analysis focused on examining the significance of total lesion glycolysis (TLG) and metabolic tumor volume (MTV) in predicting the prognosis of stages I/II non-small-cell lung cancer (NSCLC) based on 18F-FDG PET parameters. Methods Electronic databases, including Cochrane Library, PubMed, and EMBASE, were comprehensively searched for retrieving relevant articles published in the English language. Furthermore, the significance of TLG and MTV in prognosis prediction was analyzed by pooled hazard ratios (HRs). Results This work enrolled eight primary studies with 1292 I/II-stage NSCLC cases. The pooled HR (95% confidence interval [CI]) for the ability of increased TLG to predict progression-free survival (PFS) was 2.02 (1.30–2.13) (P=0.350), while for increased MTV it was 3.04 (1.92–4.81) (P=0.793). In addition, the pooled HR (95% CI) for the ability of increased TLG to predict overall survival (OS) was 2.16 (1.49–3.14) (P=0.624). However, higher MTV correlated with OS, and sensitivity analysis showed that the results were not stable. Multivariate and univariate analyses by subgroup analyses stratified by PFS of MTV and OS of TLG exhibited statistically significant differences, without any statistical heterogeneity across various articles. Conclusion The present work suggests the predictive value of PET/CT among stage I and II NSCLC patients. Our results verified that stage I/II NSCLC cases with increased TLG and MTV had a higher risk of side reactions, and TLG is related to increased mortality risk.
Highlights
Non-small-cell lung cancer (NSCLC) represents a frequently occurring lung cancer subtype, with its incidence rising globally [1]
Studies conforming to the following criteria were included: (1) studies including the histological diagnosis of stage I and II NSCLC patients; (2) studies using 18F-FDG positron emission tomography/ computed tomography (PET/CT) as the imaging modality prior to treatment, articles that reported survival data by metabolic tumor volume (MTV) or total lesion glycolysis (TLG); (3) articles published in English
Our work focused on exploring the significance of 18F-FDG PET-derived MTV/TLG in predicting the prognosis of stage I/II NSCLC cases
Summary
Non-small-cell lung cancer (NSCLC) represents a frequently occurring lung cancer subtype, with its incidence rising globally [1]. It is still responsible for most cancer-related deaths worldwide [2, 3]. TLG is determined by the multiplication of MTV with average SUV, and it can weigh tumor metabolic activity and volumetric burden [5,6,7]. TLG and MTV from 18F-fluorodeoxyglucose (FDG) positron emission tomography/ computed tomography (PET/CT) have been identified as the standard staging methods, used to monitor therapeutic response and predict prognosis of different cancers, such as NSCLC [5, 8,9,10]. It is essential to identify prognostic factors for NSCLC cases [13]
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