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Prognostic Value of Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography or PET-Computed Tomography in Cervical Cancer: A Meta-Analysis

Zhao, Qianying MD*; Feng, Yi MD*; Mao, Xuanyue BSc; Qie, Mingrong MD*

International Journal of Gynecological Cancer: September 2013 - Volume 23 - Issue 7 - p 1184–1190
doi: 10.1097/IGC.0b013e31829ee012
Review Articles

Objective We pooled the data from published studies to estimate the prognostic value of fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) or PET/computed tomography (CT) in cervical cancer patients.

Methods We searched MEDLINE, EMBASE, and PUBMED to identify studies investigating the association of 18F-FDG PET or PET/CT with clinical survival outcomes of patients with cervical cancer. The summarized hazard ratio (HR) was estimated by using fixed- or random-effect model according to heterogeneity between trails.

Results We analyzed a total number of 1854 patients from 16 studies and found that positive pretreatment FDG-PET images were significantly associated with poorer event-free survival (hazard ratio [HR], 2.681; 95% confidence interval [CI], 2.059–3.490) and overall survival (HR, 2.063; 95% CI, 1.023–4.158). Furthermore, metabolic response of therapy as shown on posttreatment PET images was also capable of predicting event-free survival and overall survival with statistical significance, and the HR was 2.030 (95% CI, 1.537–2.681) and 2.322 (95% CI, 1.485–3.630), respectively.

Conclusions Uptake of 18F-FDG on PET or PET/CT either before or after treatment has a promising value of both predicting survival outcomes for patients with cervical cancer and identifying patients for more aggressive treatment.

*Department of Gynecology and Obstetrics, West China Second University Hospital; and †Evidence-based Medicine Center, West China Hospital, Chengdu, China.

Address correspondence and reprint requests to Mingrong Qie, MD, Department of Gynecology and Obstetrics, West China Second University Hospital, No. 20 Block 3, Renminnan Road, 610041, Chengdu, Sichuan Province, China. E-mail:

The authors declare no conflicts of interest.

Received June 2, 2013

Accepted June 4, 2013

© 2013 by the International Gynecologic Cancer Society and the European Society of Gynaecological Oncology.