Prognostic Value of Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography or PET-Computed Tomography in Cervical Cancer: A Meta-Analysis

Abstract

ObjectiveWe pooled the data from published studies to estimate the prognostic value of fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) or PET/computed tomography (CT) in cervical cancer patients.MethodsWe searched MEDLINE, EMBASE, and PUBMED to identify studies investigating the association of 18F-FDG PET or PET/CT with clinical survival outcomes of patients with cervical cancer. The summarized hazard ratio (HR) was estimated by using fixed- or random-effect model according to heterogeneity between trails.ResultsWe analyzed a total number of 1854 patients from 16 studies and found that positive pretreatment FDG-PET images were significantly associated with poorer event-free survival (hazard ratio [HR], 2.681; 95% confidence interval [CI], 2.059–3.490) and overall survival (HR, 2.063; 95% CI, 1.023–4.158). Furthermore, metabolic response of therapy as shown on posttreatment PET images was also capable of predicting event-free survival and overall survival with statistical significance, and the HR was 2.030 (95% CI, 1.537–2.681) and 2.322 (95% CI, 1.485–3.630), respectively.ConclusionsUptake of 18F-FDG on PET or PET/CT either before or after treatment has a promising value of both predicting survival outcomes for patients with cervical cancer and identifying patients for more aggressive treatment.