Prognostic value of baseline metabolic tumour volume in advanced-stage Hodgkin’s lymphoma

Abstract

Our aim was to evaluate the prognostic value of initial total metabolic tumour volume (TMTV) in a population of patients with advanced-stage Hodgkin’s lymphoma (HL). We retrospectively included 179 patients with stage IIb-III-IV Hodgkin’s disease who received BEACOPP or ABVD as the first-line treatment. The initial TMTV was determined using a semi-automatic method for each patient. We analysed its prognostic value in terms of 5-year progression-free survival (PFS), overall survival, and positron emission tomography (PET) response after two courses of chemotherapy. Considering all the treatments and using a threshold of 217 cm3, TMTV was predictive of 5-year PFS and PET response after two courses of chemotherapy. In multivariable analysis involving TMTV, IPI score, and the first treatment received, TMTV remained a baseline prognostic factor for 5-year PFS. In the subgroup of patients treated with BEACOPP with a threshold of 331 cm3, TMTV was predictive of PET response, but not 5-year PFS (p = 0.087). The combined analysis of TMTV and PET response enabled the individualisation of a subgroup of patients (low TMTV and complete response on PET) with a very low risk of recurrence. Baseline TMTV appears to be a useful independent prognostic factor for predicting relapse in advanced-stage HL in ABVD subgroup, with a tendency of survival curves separation in BEACOPP subgroup.

Volumetric parameters from [18F]FDG PET/CTpredicts survival in patients with high‐grade gastroenteropancreatic neuroendocrine neoplasms

“…However, metabolic tumour volume (MTV) and total lesion glycolysis (TLG) are volumetric parameters that are obtained by using a pre‐defined threshold to delineate the tumour and its [ 18 F]FDG uptake/metabolic activity 15 . Thus, MTV and TLG are more comprehensive tools for tumour evaluation and have been shown to provide prognostic information in other cancers 16–19 . Further, by summing the MTV and TLG for all metabolically active tumours, we can calculate the total MTV (tMTV) and total TLG (tTLG) to gain knowledge about the patient's total tumour burden (disease burden).…”

“…15 Thus, MTV and TLG are more comprehensive tools for tumour evaluation and have been shown to provide prognostic information in other cancers. [16][17][18][19] Further, by summing the MTV and TLG for all metabolically active tumours, we can calculate the total MTV (tMTV) and total TLG (tTLG) to gain knowledge about the patient's total tumour burden (disease burden). Some previous studies have shown the prognostic role of different clinical and histopathological parameters on overall survival (OS) in high-grade GEP NEN.…”

Healthy Organs Uptake on Baseline 18F-FDG PET/CT as an Alternative to Total Metabolic Tumor Volume to Predict Event-Free Survival in Classical Hodgkin's Lymphoma

“…However, some publications reported no association between TMTV and Progression-Free Survival (PFS) in advanced-stage HL when treated with escalated BEACOPP ( 7 ). Furthermore, TMTV threshold varies from one study to another ( 3 – 5 , 7 , 8 ).…”

Liquid biopsy in hematological malignancies: current and future applications

“…PET/CT is considered the gold standard for staging and response assessment in cHL ( 67 , 68 ). At the time of diagnosis, the total metabolic tumor volume (TMTV) represents a functional and quantitative parameter that strongly predicts the outcome in cHL ( 69 – 71 ). Interestingly, the amount of ctDNA in plasma correlates with TMTV, indicating that ctDNA quantification may be coupled to TMTV to better predict HL outcome at the time of diagnosis ( 42 ).…”