한빛사논문
Pak, Kyoungjune MD∗,†; Yoon, Hai-Jeon‡
From the ∗Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital
†School of Medicine, Pusan National University, Busan
‡Department of Nuclear Medicine, Ewha Womans University College of Medicine, Seoul, Republic of Korea.
K.P. and H.-J.Y. contributed equally to this work.
Correspondence to: Kyoungjune Pak, MD, Hai-Jeon Yoon
Abstract
Purpose: Gynecological cancer is the most prevalent cancer among women worldwide. We performed a meta-analysis to assess the impact of 18F-FDG PET on the management of patients with recurrent gynecological cancers, including cervical, uterine, and ovarian cancers.
Methods: We systematically searched MEDLINE and EMBASE databases for English-language publications. All published studies on the impact of PET scans on the management of patients with recurrent gynecological cancers were reviewed. The proportion of management change (%), defined as the percentage of patients whose management changed after FDG PET to those who underwent FDG PET, was calculated. The data from each study were analyzed using MedCalc Statistical Software version 14.12.0 (MedCalc Software, Ostend, Belgium).
Results: Nineteen studies including 6191 patients were eligible for inclusion. The impact of FDG PET scan for detecting recurrence/metastasis in patients with gynecologic cancer was evaluated using management change rates, ranging from 9.4% to 60.7% with a pooled effect of 42.0% (95% confidence interval [CI], 34.5%-49.6%; I2 = 92.9%). In the subtype analysis, FDG PET scanning resulted in changes in the management in 48.5% (95% CI, 37.8%-59.3%; I2 = 67.8%) of cervical cancer, 34.7% (95% CI, 33.4%-36.0%; I2 = 0%) of uterine cancer, and 40.3% (95% CI, 26.7%-54.7%; I2 = 95.2%) of ovarian cancer cases.
Conclusions: FDG PET has a significant impact on the restaging of patients with gynecological cancer. These findings suggest that FDG PET should be performed, especially in cases of suspected recurrence/metastasis in the main gynecologic cancer types, including cervical, ovarian, and uterine cancers.
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