Impact of (18)F-Fluorodeoxyglucose positron emission tomography on management of cancer of unknown primary: Systematic review and meta-analysis Review
| Authors: | Woo, S.; Becker, A. S.; Do, R. K. G.; Schöder, H.; Hricak, H.; Alberto Vargas, H. |
| Review Title: | Impact of (18)F-Fluorodeoxyglucose positron emission tomography on management of cancer of unknown primary: Systematic review and meta-analysis |
| Abstract: | Background: Cancers of unknown primary (CUP) have traditionally been treated empirically, with a dismal prognosis. Compared with standard diagnostic tests, including CT and MRI, imaging with 18F-fluorodeoxyglucose (FDG) PET or PET/CT has shown the capacity to better identify the primary tumour site and detect additional sites of metastasis. However, its clinical impact is not well established. We performed a systematic review and meta-analysis of prior studies to assess the impact of FDG-PET or PET/CT on the management of patients with CUP. Materials and methods: Pubmed and EMBASE databases were searched up to 4th February 2021. Studies that reported the proportion of patients with CUP who experienced a management change after FDG-PET or PET/ computed tomography (CT) were included and the proportions were pooled using the random-effects model. Study quality was assessed using QUADAS-2. Subgroup analysis was conducted to explore heterogeneity. Results: Thirty-eight studies (involving 2795 patients) were included. The pooled proportion of patients with management changes was 35% (95% confidence interval 31%–40%). There was substantial heterogeneity among the studies (Q-test, p < 0.01; I2 = 82%). The specific reason for management change was more commonly detection of the primary site (22% [95% CI 18–28%]) than detection of additional metastatic sites (14% [95% CI 10–19%]). The pooled proportions of patients with management changes were similar among numerous subgroups (range, 32.8%–38.2%). Conclusion: FDG-PET or PET/CT had a meaningful impact on the management of patients with CUP. Approximately, a third of patients had their management changed because of FDG-PET or PET/CT results, and this finding was consistent across numerous subgroups. © 2021 Elsevier Ltd |
| Keywords: | adult; cancer chemotherapy; controlled study; cancer radiotherapy; comparative study; positron emission tomography; quality control; systematic review; fluorodeoxyglucose f 18; cancer of unknown primary site; meta analysis; computed tomography; genetic heterogeneity; meta-analysis; impact; human; male; female; article; positron emission tomography-computed tomography; cancer of unknown primary; quality assessment of diagnostic accuracy studies 2 |
| Journal Title: | European Journal of Cancer |
| Volume: | 159 |
| ISSN: | 0959-8049 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2021-12-01 |
| Start Page: | 60 |
| End Page: | 77 |
| Language: | English |
| DOI: | 10.1016/j.ejca.2021.09.031 |
| PROVIDER: | scopus |
| PUBMED: | 34742159 |
| PMCID: | PMC8671237 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 December 2021 -- Source: Scopus |
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