title: Outcome of Hodgkin Lymphoma Patients With a Posttreatment 18F-Fluoro-2-Deoxy-d-Glucose Positron Emission Tomography (FDG-PET)-Negative Residual Mass: Systematic Review and Meta-analysis.
abstract: To systematically review and meta-analyze the outcome of Hodgkin lymphoma patients with a posttreatment (18)F-fluoro-2-deoxy-d-glucose positron emission tomography (FDG-PET)-negative residual mass. A systematic PubMed/MEDLINE database search was performed. The methodological quality of included studies was assessed. The number of patients with a posttreatment non-FDG-avid residual mass and the number of these patients who developed disease relapse during follow-up were extracted from each included study. Heterogeneity in disease relapse proportions across individual studies was assessed using the I2 test, with heterogeneity defined as I(2) > 50%. Using a Freeman-Tukey transformation, the disease relapse proportions from each individual study were then meta-analyzed with either a fixed-effects model (if I2 ≤ 50 %) or a random-effects model (if I2 > 50 %). A total of 5 studies comprising a total of 727 Hodgkin lymphoma patients with an FDG-PET-negative residual mass after first-line therapy were included. The overall quality of included studies was moderate. The proportion of patients with a posttreatment non-FDG-avid residual mass who experienced disease relapse during follow-up ranged between 0% and 13.8%. There was heterogeneity in disease relapse proportions across individual studies (I2 = 61.4%). Pooled disease relapse proportion (random effects) was 6.8% (95% confidence interval: 2.6%-12.5%). The disease relapse rate in Hodgkin lymphoma patients with a FDG-PET-negative residual mass after first-line therapy is approximately 6.8%. Considering the existing literature, the presence of a non-FDG-avid residual mass has not been proven yet to be associated with a worse outcome than a posttreatment FDG-PET-based complete remission status without a residual mass.
authors.affiliation: a Department of Radiology and Nuclear Medicine , University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Hugo J A
authors.initials: HJ
authors.lastname: Adams
authors.affiliation: a Department of Radiology and Nuclear Medicine , University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Rutger A J
authors.initials: RA
authors.lastname: Nievelstein
authors.affiliation: a Department of Radiology and Nuclear Medicine , University Medical Center Utrecht , Utrecht , The Netherlands.
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Kwee
mesh_terms: D005260:Female; D019298:Glucose-6-Phosphate / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D018365:Neoplasm, Residual; D049268:Positron-Emission Tomography / Q000379:methods*; D011859:Radiography
chemical_list: C047515:2-fluoro-2-deoxyglucose-6-phosphate; D019298:Glucose-6-Phosphate
keywords: FDG-PET; Hodgkin lymphoma; meta-analysis; posttreatment; residual mass; systematic review