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Prognostic significance of [18F]FDG PET metabolic parameters in adults and children with soft-tissue sarcoma: a meta-analysis

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Abstract

Background

Soft-tissue sarcomas (STS) represent a diverse group of rare malignancies, underscoring the need for precise risk stratification. [18F]fluoro‑2‑deoxy‑2‑d‑glucose positron emission tomography ([18F]FDG PET) imaging parameters have been proposed as potential prognostic indicators in several cancer types, yet their significance in STS remains under investigation. This study aimed to synthesize the available evidence and assess the prognostic value of these parameters.

Methods

A systematic review and meta-analysis was conducted, employing a comprehensive literature search across multiple databases. The prognostic value of [18F]FDG PET parameters, including pre- and post- treatment standardized uptake values (SUV1, SUV2), pretreatment metabolic tumor volume (MTV1) and total lesion glycolysis (TLG1) on event-free survival (EFS) and overall survival (OS) in patients with STS was examined.

Results

Thirty-one studies with 1,932 patients were identified. The analyses demonstrated significant relationships between higher SUV1 (hazard ratio, HR 1.68 for EFS and 3.07 for OS, p < 0.001), SUV2 (HR 3.13 for EFS and 2.09 for OS, p < 0.001 and p = 0.001 respectively), MTV1 (HR 2.29 for EFS and 3.05 for OS, p = 0.011 and p < 0.001 respectively), TLG1 (HR 2.85 for EFS and 3.23 for OS, p = 0.032 and p = 0.002 respectively) and poorer survival outcomes. However, the association of these parameters with survival outcomes was non-significant in pediatric patients.

Conclusion

This study suggests that [18F]FDG PET parameters could serve as important prognostic markers in adults with STS, but not in pediatric patients. Future studies with larger cohorts and uniform methodologies are critical to confirm and build upon these findings.

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Availability of data and materials

The authors declare that all data supporting the findings of this study are available within the article.

Abbreviations

[18F]FDG:

[18F]fluoro‑2‑deoxy‑2‑d‑glucose

CI:

Confidence interval

EFS:

Event-free survival

FNCLCC:

Fédération Nationale des Centres de Lutte Contre Le Cancer Sarcoma Group

HR:

Hazard ratio

IQR:

Interquartile range

M:

Multicenter

Me:

Median

MTV:

Metabolic tumor volume

NA:

Not applicable

NAC:

Neoadjuvant chemotherapy

NR:

Not reported

OS:

Overall survival

PET:

Positron emission tomography

Pro:

Prospective

Prov:

Provided

REML:

REstricted Maximum–Likelihood

Retro:

Retrospective

RMS:

Rhabdomyosarcoma

ROC:

Receiver operating characteristic curve

S:

Single center

SD:

Standard deviation

STS:

Soft-tissue sarcoma

SUV:

Standardized uptake value

TLG:

Total lesion glycolysis

TSA:

Trial sequential analysis

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Authors and Affiliations

  1. Department of PET and Radionuclide Diagnostics, Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Samory Mashela Str. 1, 117997, Moscow, Russia

    M. Ya. Yadgarov, D. Yu. Kachanov & Yu. N. Likar

  2. V. A. Negovsky Research Institute of General Reanimatology of the Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia

    M. Ya. Yadgarov & L. B. Berikashvili

  3. K+31 City Hospital, Moscow, Russia

    E. S. Rakova

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MY, YL contributed to the design and implementation of the research. MY, LB, ER preformed the analysis of the results. MY, LB, ER, DK, YL wrote of the manuscript. All authors discussed the results and commented on the manuscript.

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Yadgarov, M.Y., Berikashvili, L.B., Rakova, E.S. et al. Prognostic significance of [18F]FDG PET metabolic parameters in adults and children with soft-tissue sarcoma: a meta-analysis. Clin Transl Imaging (2024). https://doi.org/10.1007/s40336-024-00620-9

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