Pre- and post-treatment FDG PET-CT as a predictor of patient outcomes in anal squamous cell carcinoma: A systematic review and meta-analysis

Benjamin M. Mac Curtain, Wanyang Qian, Jack Bell, Aaron O'Mahony, Hugo C. Temperly, Zi Qin Ng

Research output: Contribution to journalReview articlepeer-review

Abstract

Anal squamous cell carcinoma (ASCC) has a generally acceptable outlook in terms of survival. 18-fluorodeoxyglucose-positron emission tomography/computer tomography (FDG PET-CT) is not recommended for routine monitoring post-ASCC treatment. We examine herein if FDG PET-CT has a use in the prognostic evaluation of patients with ASCC, what FDG PET-CT metrics are of value and if a pre- or post-chemo/radiotherapy scan is more prognostic of outcomes. PubMed, EMBASE and Cochrane Central Registry of Controlled Trials were comprehensively searched until 3 May, 2023. A modified Newcastle Ottawa scale was used to assess for study bias. We present our systematic review alongside pooled hazard ratios (HR) for maximum standardised uptake values (SUV) as a predictor of overall survival (OS) and progression-free survival (PFS). Seven studies including 523 patients were included in our systematic review. Current evidence suggests that SUV maximum and median, metabolic tumour volume, total lesion glycolysis and complete and partial metabolic response may be prognostic when considering overall or progression-free survival (OS)/(PFS) along with local recurrence (LR). Pooled HR from two included studies indicate SUV max is prognostic of OS, HR 1.179, CI (1.039-1.338), P = 0.011 and PFS 1.176, CI (1.076-1.285), P < 0.01. FDG PET-CT may have a role to play in the prognostic evaluation of ASCC patients. Current evidence suggests post-treatment scanning may hold superior prognostic value at this time.
Original languageEnglish
Pages (from-to)634-646
Number of pages13
JournalJournal of Medical Imaging and Radiation Oncology
Volume67
Issue number6
Early online date13 Aug 2023
DOIs
Publication statusPublished - Sept 2023
Externally publishedYes

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