Published online Dec 28, 2013. doi: 10.4329/wjr.v5.i12.484
Revised: October 17, 2013
Accepted: December 9, 2013
Published online: December 28, 2013
AIM: To assess the prognostic value and risk classification improvement of metabolic staging (MS) with Initial 2-[18F]-fluoro-2-desoxy-D-glucose positron emission tomography (FDG-PET) in initial staging of Hodgkin’s Lymphoma (HL) patients to predict 5 years overall survival (5y-OS) and event free survival (EFS).
METHODS: A total of 275 patients were included in this retrospective study, 155 patients were staged with conventional anatomical staging (AS), and 120 also submitted to MS (FDG-PET). Prognostic analysis compared 5y-OS and 5y-EFS of patients staged with AS and MS. Risk-adjusted models incorporated clinical risk factors, computed tomography and FDG-PET staging.
RESULTS: During the follow up of 267 evaluated patients, 220 (122 AS and 98 MS) achieved complete remission after first-line therapy (median follow-up: 70 ± 29 mo), treatment failure occurred in 79 patients and 34 died. The 5y-EFS for early vs advanced disease in AS patients was 79.3% and 66.7%, and 85.6% and 53.6% in MS patients, respectively (P < 0.01). The 5y-OS for early and advanced disease with AS was 91.3% and 81.5%, and 97.5% and 80.7% for patients staged with MS, respectively. Cox proportional hazards analysis demonstrated that FDG-PET added signiﬁcant prognostic information and improved risk prediction (P = 0.02).
CONCLUSION: Initial staging FDG-PET could be used as an accurate and independent predictor of OS and EFS in HL, with impact in 5y-EFS and OS.
Core tip: Initial 2-[18F]-fluoro-2-desoxy-D-glucose positron emission tomography (FDG-PET) has impact in the determination of the event free survival and overall survival (OS) in Hodgkin’s Lymphoma patients, also initial staging with FDG-PET was the strongest predictor of OS and event free survival of the evaluated variables analyzed. In the currently era of tailoring therapy to an individual level, initial staging might play an even more important role.