PROSPERO

International prospective register of systematic reviews

Prognostic value of volume-based metabolic parameters of 18F-FDG PET/CT in uterine

cervical cancer: a systematic review and meta-analysis
Sungmin Woo, Sangwon Han

Citation
Sungmin Woo, Sangwon Han. Prognostic value of volume-based metabolic parameters of 18F-
FDG PET/CT in uterine cervical cancer: a systematic review and meta-analysis. PROSPERO 2018
CRD42018086327 Available from:
http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018086327

Review question
What is the prognostic value of volume-based metabolic parameters of 18F-FDG PET/CT, including
metabolic tumor volume (MTV), and total lesion glycolysis (TLG), in uterine cervical cancer in terms of
progression- or recurrence-free survival and overall survival?

Searches
Sources: MEDLINE, EMBASE, and The Cochrane Library
Search date: inception to January 2018
Language restrictions: English
Search Strategy: ("cervix" OR "cervical") AND ("PET" OR "positron") AND ("MTV" OR "TLG" OR "volumetric"
OR "metabolic tumor volume" OR "total lesion glycolysis") AND ("survival" OR "prognosis" OR "prognostic"
OR "event" OR "hazard")

Types of study to be included

Original research articles are to be included. Case studies/series, conference abstracts, review articles,
editorials and letters/letter replies will be excluded.

Condition or domain being studied

Disease: Uterine cervical cancer.
Condition: progression/recurrence and death (progression- or recurrence-free survival and overall survival).

Participants/population
1. Inclusion:
18 F-FDG PET used as pre-treatment imaging tool, studies limited to patients with uterine cervical cancer
2. Exclusion:
Patients with other tumors.

Intervention(s), exposure(s)
Volume-based metabolic parameters of 18F-FDG PET/CT including metabolic tumor volume (MTV) and total
lesion glycolysis (TLG).

Comparator(s)/control
None.

Context
Primary outcome(s)
Event-free survival will be defined as either progression-free survival or recurrence-free survival and will be
determined based on the date of initiation of treatment to the date of recurrence/metastasis.

Secondary outcome(s)

Page: 1 / 3
PROSPERO
International prospective register of systematic reviews

Overall survival, will be based on the date of initiation of treatment to the date of death by any cause.

Data extraction (selection and coding)

Risk of bias (quality) assessment
Two independent researchers will independently perform risk of bias and quality assessment. Then,
discrepancies will be resolved by consensus. Risk of bias will be assessed using Quality in Prognosis
Studies (QUIPS) tool that includes the following six domains: participants, attrition, prognostic factor
measurement, outcome measurement, study confounding, and statistical analysis and reporting. Funnel
plots will be used to assess publication bias.

Strategy for data synthesis

Measured effect size will be hazard ratio (HR). Survival data will be extracted using methods reported by
Parmar et al (Extracting summary statistics to perform meta-analyses of the published literature for survival
endpoints. Stat Med.1998;17:2815–2834). Univariate HR estimates and their corresponding 95% confidence
intervals (CIs) will be extracted directly from each study (if provided in the study). If not, HR will be calculated
indirectly using the following information: p-values (log-rank test), 95% CI, number at risk and number of
events. If Kaplan-Meier curves are provided in the study, they will be graphically read using Engauge
Digitizer program (version 3.0; http://digitizer. sourceforge.net). When so, HRs will be estimated under the
assumption that patient censoring occurred at a constant rate during follow-up.

Analysis of subgroups or subsets

Subgroup analysis will be done subgroups stratified according to two variables: (1) outcome (event-free
survival or overall survival) and (2) metabolic volumetric parameter (MTV vs TLG). If sufficient number of
studies are present, additional subgroup analysis will be performed according to subgroups based on (3)
measurement location (PET parameters measured in primary tumor, lymph node or metastasis) and (4)
treatment type (surgery, concurrent chemoradiation, radiation therapy, and etc.).

Contact details for further information

Sungmin Woo
j_crew7@hotmail.com

Organisational affiliation of the review

Department of Radiology, Seoul National University College of Medicine

Review team members and their organisational affiliations

Dr Sungmin Woo. Seoul National University College of Medicine
Dr Sangwon Han. Department of Nuclear Medicine, University of Ulsan College of Medicine

Anticipated or actual start date

17 January 2018

Anticipated completion date

04 April 2018

Funding sources/sponsors
None.

Conflicts of interest
None known

Language
English

Country

Page: 2 / 3
 PROSPERO
International prospective register of systematic reviews

South Korea

Stage of review
Review_Ongoing

Subject index terms status

Subject indexing assigned by CRD

Subject index terms

Female; Fluorodeoxyglucose F18; Humans; Multimodal Imaging; Positron Emission Tomography Computed
Tomography; Positron-Emission Tomography; Prognosis; Uterine Cervical Neoplasms

Date of registration in PROSPERO

25 January 2018

Date of publication of this version

25 January 2018

Details of any existing review of the same topic by the same authors
Stage of review at time of this submission

Stage Started Completed

Preliminary searches Yes No
Piloting of the study selection process No No

Formal screening of search results against eligibility criteria No No

Data extraction No No
Risk of bias (quality) assessment No No

Data analysis No No

Versions
25 January 2018

PROSPERO
This information has been provided by the named contact for this review. CRD has accepted this information in good
faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration
record, any associated files or external websites.

Page: 3 / 3

Powered by TCPDF (www.tcpdf.org)