Prognostic significance of (18)F-FDG PET at diagnosis in patients with soft tissue sarcoma and bone sarcoma; systematic review and meta-analysis

Eur J Cancer. 2016 May:58:104-11. doi: 10.1016/j.ejca.2016.02.007. Epub 2016 Mar 15.


Purpose: The usefulness of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) for the survival prognosis in soft tissue sarcoma (STS) and bone sarcoma (BS) is controversial. The objective of this systematic review was to provide an up-to-date and unprecedented summary of the prognostic value of (18)F-FDG PET at diagnosis in STS and BS.

Methods: Studies evaluating pre-treatment (18)F-FDG PET for overall survival of STS and BS were systematically searched for in MEDLINE, EMBASE, and Web of Science. Comparative analyses of the pooled hazard ratios (HR) of overall survival were performed between patients with high and low maximum standardised uptake value (SUVmax). The quality of study designs was evaluated using the Newcastle-Ottawa scale (NOS) for quality assessment of cohort studies. P < 0.05 was defined as statistically significant.

Results: A total of six studies comprising 514 patients with STS and BS were considered for the meta-analysis. The pooled HR for overall survival was 1.22 (95% confidence interval: 1.03-1.46), suggesting that high SUVmax predicts a significantly shorter overall survival period than low SUVmax (P = 0.03). Additional subgroup analyses using patients with STS alone showed that high SUVmax might predict poorer overall survival than low SUVmax (P = 0.004), although only two studies consisting of 96 patients were included. The overall quality of the included studies evaluated by the NOS assessment was adequate.

Conclusion: (18)F-FDG PET at diagnosis provides a very useful predictive tool for patients with STS and BS.

Keywords: (18)F-FDG PET; Bone sarcoma; Meta-analysis; Soft tissue sarcoma; Survival.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Bone Neoplasms / diagnostic imaging*
  • Bone Neoplasms / mortality
  • Bone Neoplasms / therapy
  • Chi-Square Distribution
  • Fluorodeoxyglucose F18*
  • Humans
  • Odds Ratio
  • Osteosarcoma / diagnostic imaging*
  • Osteosarcoma / mortality
  • Osteosarcoma / therapy
  • Positron-Emission Tomography*
  • Predictive Value of Tests
  • Prognosis
  • Radiopharmaceuticals*
  • Risk Factors
  • Sarcoma / diagnostic imaging*
  • Sarcoma / mortality
  • Sarcoma / therapy
  • Soft Tissue Neoplasms / diagnostic imaging*
  • Soft Tissue Neoplasms / mortality
  • Soft Tissue Neoplasms / therapy
  • Survival Analysis


  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18