Open AccessPET metabolic tumor volume as a new prognostic factor in childhood rhabdomyosarcoma
Author(s) -
H. Fayolle,
Nina Jehanno,
Valérie LauwersCancès,
MariePierre Castex,
Daniel Orbach,
Thomas Mognetti,
Nadège Corradini,
Pierre Payoux,
Anne Hitzel
Publication year - 2022
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0261565
Subject(s) - medicine , univariate analysis , multivariate analysis , oncology , rhabdomyosarcoma , retrospective cohort study , pathology , sarcoma
Purpose Childhood RMS is a rare malignant disease in which evaluation of tumour spread at diagnosis is essential for therapeutic management. F-18 FDG-PET imaging is currently used for initial RMS disease staging. Materials and methods This multicentre retrospective study in six French university hospitals was designed to analyse the prognostic accuracy of MTV at diagnosis for patients with RMS between 1 January 2007 and 31 October 2017, for overall (OS) and progression-free survival (PFS). MTV was defined as the sum of the primitive tumour and the largest metastasis, where relevant, with a 40% threshold of the primary tumour SUVmax. Additional aims were to define the prognostic value of SUVmax, SUVpeak, and bone lysis at diagnosis. Results Participants were 101 patients with a median age of 7.4 years (IQR [4.0-12.5], 62 boys), with localized disease (35 cases), regional nodal spread (43 cases), or distant metastases (23). 44 patients had alveolar subtypes. In a univariate analysis, a MTV greater than 200 cm 3 was associated with OS (HR = 3.47 [1.79;6.74], p <0.001) and PFS (HR = 3.03 [1.51;6.07], p = 0.002). SUVmax, SUVpeak, and bone lysis also influenced OS (respectively p = 0.005, p = 0.004 and p = 0.007) and PFS ( p = 0.029, p = 0.019 and p = 0.015). In a multivariate analysis, a MTV greater than 200 cm 3 was associated with OS (HR = 2.642 [1.272;5.486], p = 0.009) and PFS (HR = 2.707 [1.322;5.547], p = 0.006) after adjustment for confounding factors, including SUVmax, SUVpeak, and bone lysis. Conclusion A metabolic tumor volume greater than 200 cm 3 , SUVmax, SUVpeak, and bone lysis in the pre-treatment assessment were unfavourable for outcome.