Huang Mingxing, Wang Weichen, Wang Rang, Tian Rong
Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China.
Eur Radiol. 2025 Jun;35(6):3396-3408. doi: 10.1007/s00330-024-11207-3. Epub 2024 Nov 21.
This study aims to evaluate the prognostic implications of pretreatment [F]FDG-PET metrics in esophageal cancer patients through a meta-analysis of the existing literature.
We carefully searched electronic databases, including PubMed and Embase, from inception to April 1, 2024, to identify studies describing the prognostic value of pretreatment PET metrics for advanced esophageal cancer. Clinical endpoints examined were overall survival (OS), recurrence-free survival (RFS)/disease-free survival (DFS), and progression-free survival (PFS). Hazard ratios (HRs) for PFS and OS were taken directly from the original reports.
Forty-seven publications, including 5504 patients, were included in our analysis. OS and PFS were analyzed in 31 and nine studies, respectively, and DFS/RFS was analyzed in 16 studies. The comprehensive pooled analysis revealed significant associations between metabolic parameters derived from positron emission tomography (PET) imaging and clinical outcomes. Expressly, the pooled HR indicated that patients with higher SUVmax were significantly associated with poor PFS (HR: 1.06; 95% CI: 1.01-1.12, p = 0.011) and poor RFS/DFS (HR: 1.09; 95% CI: 1.02-1.18, p = 0.019). Patients with higher SUVmean were significantly associated with poorer OS (HR: 1.07; 95% CI: 1.01-1.14, p = 0.025). High MTV was significantly associated with inferior OS (HR: 1.02; 95% CI: 1.00-1.05, p = 0.049). High TLG was significantly associated with poorer RFS/DFS (HR: 2.02; 95% CI: 1.11-3.68, p = 0.022).
This study unveiled pretreatment FDG-derived parameters as valuable prognostic indicators in assessing esophageal cancer outcomes. Specifically, SUVmax is associated with PFS and RFS/DFS. SUVmean and MTV were correlated with OS, and TLG was only associated with RFS/DFS.
Question Inconsistent findings on the prognostic value of pretreatment [F]FDG PET parameters in esophageal cancer require comprehensive analysis to clarify their role in outcome prediction. Findings Higher pretreatment [F]FDG-PET metrics (SUVmax, SUVmean, MTV, TLG) are associated with poor survival outcomes, emphasizing their potential value in enhancing prognostic assessments for esophageal cancer. Clinical relevance This study highlights the prognostic significance of pretreatment [F]FDG-PET metrics in esophageal cancer, providing valuable insights for patient outcome prediction and potentially guiding personalized treatment strategies.
本研究旨在通过对现有文献的荟萃分析，评估治疗前[F]FDG-PET指标对食管癌患者的预后意义。
我们仔细检索了从数据库建立至2024年4月1日的电子数据库，包括PubMed和Embase，以确定描述治疗前PET指标对晚期食管癌预后价值的研究。所检查的临床终点为总生存期（OS）、无复发生存期（RFS）/无病生存期（DFS）和无进展生存期（PFS）。PFS和OS的风险比（HRs）直接取自原始报告。
我们的分析纳入了47篇出版物，共5504例患者。分别在31项和9项研究中分析了OS和PFS，在16项研究中分析了DFS/RFS。综合汇总分析显示，正电子发射断层扫描（PET）成像得出的代谢参数与临床结局之间存在显著关联。具体而言，汇总HR表明，SUVmax较高的患者与较差的PFS（HR：1.06；95%CI：1.01-1.12，p=0.011）和较差的RFS/DFS（HR：1.09；95%CI：1.02-1.18，p=0.019）显著相关。SUVmean较高的患者与较差的OS显著相关（HR：1.07；95%CI：1.01-1.14，p=0.025）。高代谢肿瘤体积（MTV）与较差的OS显著相关（HR：1.02；95%CI：1.00-1.05，p=0.049）。高总病变糖酵解（TLG）与较差的RFS/DFS显著相关（HR：2.02；95%CI：1.11-3.68，p=0.022）。
本研究揭示了治疗前FDG衍生参数是评估食管癌预后的有价值指标。具体而言，SUVmax与PFS和RFS/DFS相关。SUVmean和MTV与OS相关，而TLG仅与RFS/DFS相关。
问题 关于治疗前[F]FDG PET参数对食管癌预后价值的研究结果不一致，需要综合分析以阐明其在结局预测中的作用。发现 较高的治疗前[F]FDG-PET指标（SUVmax、SUVmean、MTV、TLG）与较差的生存结局相关，强调了它们在增强食管癌预后评估中的潜在价值。临床意义 本研究突出了治疗前[F]FDG-PET指标对食管癌的预后意义，为患者结局预测提供了有价值的见解，并可能指导个性化治疗策略。
