To perform a systematic review and meta-analysis on the prognostic value of 18F-FDG PET-derived volume-based parameters regarding metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients with ovarian cancer.
Pubmed and EMBASE databases were searched up to February 12, 2018 for studies which evaluated MTV or TLG as a prognostic factor in ovarian cancer with progression-free (PFS) and overall survival (OS) as the endpoints. Hazard ratios (HRs) were meta-analytically pooled using the random-effects model. Multiple subgroup analyses based on clinicopathological and PET variables were performed.
Eight studies with 473 patients were included. The pooled HRs of MTV and TLG for PFS were 2.50 (95% CI 1.79-3.48; p < 0.00001) and 2.42 (95% CI 1.61-3.65; p < 0.0001), respectively. Regarding OS, the pooled HRs of MTV and TLG were 8.06 (95% CI 4.32-15.05; p < 0.00001) and 7.23 (95% CI 3.38-15.50; p < 0.00001), respectively. Multiple subgroup analyses consistently showed that MTV and TLG were significant prognostic factors for PFS with pooled HRs ranging from 2.35 to 2.58 and from 1.73 to 3.35, respectively.
MTV and TLG from 18F-FDG PET were significant prognostic factors in patients with ovarian cancer. Despite the clinical heterogeneity and difference in methodology between the studies, patients with a high MTV or TLG have a higher risk of disease progression or death.