Journal Article

PET metabolic tumor volume as a new prognostic factor in childhood rhabdomyosarcoma

Jehanno, Nina, Hitzel, Anne, Fayolle, Helio, Castex, Marie-Pierre, Lauwers-Cances, Valerie, Payoux, Pierre, Nadège, Corradini, Orbach, Daniel, Mognetti, Thomas

2022

Overview

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. 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. 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 cm3 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 cm3 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. A metabolic tumor volume greater than 200 cm3, SUVmax, SUVpeak, and bone lysis in the pre-treatment assessment were unfavourable for outcome.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Biopsy / Bone tumors / Cancer / Cancer therapies / Chemotherapy / Child / Child, Preschool / Childhood / Children / Development and progression / Diagnosis / Disease / Disease management / Female / Fluorine isotopes / Fluorodeoxyglucose F18 / Hospitals / Human health and pathology / Humans / Life Sciences / Lymphatic system / Lymphoma / Lysis / Male / Medical prognosis / Medicine and Health Sciences / Metabolism / Metastases / Metastasis / Multivariate analysis / Nuclear medicine / Oncology / Patients / Pediatric research / Pediatrics / PET imaging / Positron emission / Positron emission tomography / Positron-Emission Tomography - methods / Prognosis / Radiation therapy / Radioisotopes / Retrospective Studies / Rhabdomyosarcoma / Rhabdomyosarcoma - diagnostic imaging / Rhabdomyosarcoma - metabolism / Rhabdomyosarcoma - pathology / Sarcoma / Surgery / Tomography / Tumor Burden / Tumors / Tumors in children