Abstract
BackgroundF-18- fluorodeoxyglucose Positron emission tomography (18FDG-PET) has been widely used in clinical practice. However, the prognostic value of the pretreatment standardized uptake value (SUV) for patients with gastric cancer remains controversial.MethodsMajor databases were systematically searched. The quality of the included studies was assessed using the Newcastle–Ottawa scale; the PET protocols were also evaluated. The pooled hazard ratio (HR) for overall survival (OS) and recurrence-free survival (RFS) were used to estimate the effect size. Data from the included studies were analyzed using Review Manager Software version 5.2.ResultsEight studies with 1080 patients were included. The pooled HR for OS of six studies including 672 patients was 1.72 (95% CI [1.28–2.3], p = 0.0004, I2 = 0%), indicating that patients with high SUVs may have poor prognosis. The pooled HR for RFS was 1.70 (95% CI [1.20–2.39], p = 0.003, I2 = 0%). Subgroup analysis based on the cutoff values determining method indicated that the receiver operating characteristic (ROC) method could better define the cutoff value. Subgroup analysis based on the therapeutic strategies used subsequently indicated the significant prognostic value of SUV.ConclusionIn conclusion, our meta-analysis indicated that pretreatment SUV in primary lesions can be an important prognostic factor for overall survival and recurrence-free survival in patients with gastric cancer. High SUVs may indicate poor prognosis.
Highlights
F-18- fluorodeoxyglucose Positron emission tomography (18FDG-positron emission tomography (PET)) has been widely used in clinical practice
Major improvements have been achieved in the early detection and screening of gastric cancer, many individuals are still diagnosed with advanced-stage gastric cancer every year, which underscores the poor prognosis of the disease [2]
The primary elements extracted consisted of the following: (1) the FDG avidity, which was defined as the focally increased 18F–FDG uptake exceeding the surrounding normal tissue [4]; (2) types of standardized uptake value (SUV), correction of SUVs, definition of threshold SUVs; (3) hazard ratio (HR) associated with the FDG uptake value for overall survival (OS), recurrence-free survival (RFS), progression-free survival (PFS), and their respective 95% confidence interval (CI)
Summary
F-18- fluorodeoxyglucose Positron emission tomography (18FDG-PET) has been widely used in clinical practice. The prognostic value of the pretreatment standardized uptake value (SUV) for patients with gastric cancer remains controversial. Gastric cancer is one of the most common types of cancer worldwide and is the second leading cause of cancer-related death, with approximately 700,000 deaths annually [1]. A During the 1980s, positron emission tomography (PET) was incorporated into the clinical practice [3]. FDG-PET uses 18fluoro-deoxy-glucose (18F–FDG), a glucose analog, as tracer to evaluate the metabolic status of the morphological lesions. In order to quantify a lesion’s metabolic activity, standardized uptake value (SUV) is introduced to clinical practice. The SUV value provides a semi-quantitative analysis and description of the radioactivity in a lesion [4]. A circular region of interest placed in the FDG-accumulating area
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