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09-05-2024 | Original Article

The prognostic value of lymph node to primary tumor standardized uptake value ratio in cancer patients: a meta-analysis

Authors: Wing-Keen Yap, Ken-Hao Hsu, Ting-Hao Wang, Chia-Hsin Lin, Chung-Jan Kang, Shih-Ming Huang, Huan-Chun Lin, Tsung-Min Hung, Kai-Ping Chang, Tsung-You Tsai

Published in: Annals of Nuclear Medicine

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Abstract

Objective

The lymph node to primary tumor standardized uptake value ratio (NTR) is an innovative parameter derived from positron emission tomography/computed tomography (PET/CT) scans that captures the intricate relationship between primary tumors and associated lymph nodes. This meta-analysis aimed to investigate the prognostic value of NTR in cancer patients.

Methods

A systematic search of PubMed, Cochrane, and Embase databases was conducted to identify studies investigating the association between NTR and survival outcomes in cancer patients. The pooled adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were calculated using a random-effects model.

Results

Twelve studies comprising a total of 2037 patients were included in the meta-analysis. Elevated NTR was significantly associated with worse overall survival aHR (2.21, 95% CI 1.63 to 2.99), disease-free survival aHR (3.27, 95% CI 2.12 to 5.05), and distant metastasis-free survival aHR (2.07, 95% CI 1.55 to 2.78) in cancer patients. Subgroup analyses by cancer type showed consistent results across various malignancies, including head and neck squamous cell carcinoma, endometrial carcinoma, lung cancer, breast cancer, and nasopharyngeal carcinoma.

Conclusions

This meta-analysis provides evidence for a significant association between elevated NTR and worse survival outcomes in cancer patients. Elevated NTR may serve as a useful prognostic biomarker for cancer patients and could potentially be used to guide treatment decisions and monitor disease progression. Future studies should aim to validate these findings in larger and more diverse patient populations and investigate the underlying mechanisms for the observed association between NTR and survival outcomes.
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Metadata
Title
The prognostic value of lymph node to primary tumor standardized uptake value ratio in cancer patients: a meta-analysis
Authors
Wing-Keen Yap
Ken-Hao Hsu
Ting-Hao Wang
Chia-Hsin Lin
Chung-Jan Kang
Shih-Ming Huang
Huan-Chun Lin
Tsung-Min Hung
Kai-Ping Chang
Tsung-You Tsai
Publication date
09-05-2024
Publisher
Springer Nature Singapore
Published in
Annals of Nuclear Medicine
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI
https://doi.org/10.1007/s12149-024-01933-5