Predicting time to treatment in follicular lymphoma on watchful waiting using baseline metabolic tumour burden
Purpose Asymptomatic patients with follicular lymphoma (FL) and a low tumour burden can be followed without initial therapy, a strategy called watchful waiting (WW). Prediction of the time to treatment (TTT) is still a challenge. We investigated the prognostic value of baseline total metabolic tumou...
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| Veröffentlicht in: | Journal of cancer research and clinical oncology 2023-07, Vol.149 (7), p.2783-2791 |
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| creator | Leccisotti, Lucia Maccora, Daria Malafronte, Rosalia D’Alò, Francesco Maiolo, Elena Annunziata, Salvatore Rufini, Vittoria Giordano, Alessandro Hohaus, Stefan |
| description | Purpose
Asymptomatic patients with follicular lymphoma (FL) and a low tumour burden can be followed without initial therapy, a strategy called watchful waiting (WW). Prediction of the time to treatment (TTT) is still a challenge. We investigated the prognostic value of baseline total metabolic tumour volume (TMTV) and whole-body total lesion glycolysis (WB-TLG) to predict TTT in patients with FL on WW.
Methods
We conducted a retrospective study of 54 patients with FL (grade 1–3a) diagnosed between June 2013 and December 2019, staged with FDG PET/CT, and managed on WW. Median age was 62 years (range 34–85), stage was advanced (III–IV) in 57%, and FLIPI score was intermediate to high (≥ 2) in 52% of the patients.
Results
The median TMTV and WB-TLG were 7.1 and 43.3, respectively. With a median follow-up of 59 months, 41% of patients started immuno-chemotherapy. The optimal cut-points to identify patients with TTT within 24 months were 14 for TMTV (AUC 0.70; 95% CI 51–88) and 64 for WB-TLG (AUC 0.71; 95% CI 52–89) (
p
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| doi_str_mv | 10.1007/s00432-022-04138-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10314847</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2831888139</sourcerecordid><originalsourceid>FETCH-LOGICAL-c508t-d81d52e6fdaf9780b8cee21eab7e62d512565cb0c1781f5c25d5cefb468a6ec3</originalsourceid><addsrcrecordid>eNqFkcluFDEQhlsIRELgBTggS1y4NLi8teeEUMQmRYJD7pbbXT3jyG0Ptpsob48nE8JygIPX-v6yq_6uew70NVA6vCmUCs56ytoQwHXPH3SncLgCzuXD7pTCAL1koE66J6Vc0XaWA3vcnXA5DBug6rSLXzNO3lUft6T6BUlNpGa0dcFYiY9kTiF4twabSbhZ9ru0WJIiubbV7eY1tI2_Fa_lMI-2YPARyYLVjqkpSV2XtGYyrnnC-LR7NNtQ8NndetZdfnh_ef6pv_jy8fP5u4veSaprP2mYJEM1T3beDJqO2iEyQDsOqNgkgUkl3UgdDBpm6ZicpMN5FEpbhY6fdW-PaffruODkWi3ZBrPPfrH5xiTrzZ-R6Hdmm74boByEFkPL8OouQ07fVizVLL44DMFGTGsxnAoqBKNK_BdlSgu6UaBoQ1_-hV613sTWCcM0B6018E2j2JFyOZWScb7_OFBzcN4cnTfNeXPrvOFN9OL3ku8lP61uAD8CpYXiFvOvt_-R9gcL17wh</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2831888139</pqid></control><display><type>article</type><title>Predicting time to treatment in follicular lymphoma on watchful waiting using baseline metabolic tumour burden</title><source>SpringerLink Journals - AutoHoldings</source><creator>Leccisotti, Lucia ; Maccora, Daria ; Malafronte, Rosalia ; D’Alò, Francesco ; Maiolo, Elena ; Annunziata, Salvatore ; Rufini, Vittoria ; Giordano, Alessandro ; Hohaus, Stefan</creator><creatorcontrib>Leccisotti, Lucia ; Maccora, Daria ; Malafronte, Rosalia ; D’Alò, Francesco ; Maiolo, Elena ; Annunziata, Salvatore ; Rufini, Vittoria ; Giordano, Alessandro ; Hohaus, Stefan</creatorcontrib><description>Purpose
Asymptomatic patients with follicular lymphoma (FL) and a low tumour burden can be followed without initial therapy, a strategy called watchful waiting (WW). Prediction of the time to treatment (TTT) is still a challenge. We investigated the prognostic value of baseline total metabolic tumour volume (TMTV) and whole-body total lesion glycolysis (WB-TLG) to predict TTT in patients with FL on WW.
Methods
We conducted a retrospective study of 54 patients with FL (grade 1–3a) diagnosed between June 2013 and December 2019, staged with FDG PET/CT, and managed on WW. Median age was 62 years (range 34–85), stage was advanced (III–IV) in 57%, and FLIPI score was intermediate to high (≥ 2) in 52% of the patients.
Results
The median TMTV and WB-TLG were 7.1 and 43.3, respectively. With a median follow-up of 59 months, 41% of patients started immuno-chemotherapy. The optimal cut-points to identify patients with TTT within 24 months were 14 for TMTV (AUC 0.70; 95% CI 51–88) and 64 for WB-TLG (AUC 0.71; 95% CI 52–89) (
p
< 0.005). The probability of not having started treatment within 24 months was 87% for TMTV < 14 and 53% for TMTV ≥ 14 (
p
< 0.005). TMTV was independent of the FLIPI score for TTT prediction. Patients with both FLIPI ≥ 2 and TMTV ≥ 14 had only an 18% probability of not having started treatment at 36 months, while this probability was 75% in patients with TMTV < 14.
Conclusion
Metabolic tumour volume parameters may add information to clinical scores to better predict TTT and better stratify patients for interventional studies.</description><identifier>ISSN: 0171-5216</identifier><identifier>EISSN: 1432-1335</identifier><identifier>DOI: 10.1007/s00432-022-04138-3</identifier><identifier>PMID: 35779106</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Cancer Research ; Chemotherapy ; Glycolysis ; Hematology ; Internal Medicine ; Lymphoma ; Medicine ; Medicine & Public Health ; Metabolism ; Oncology ; Patients ; Positron emission tomography ; prediction ; probability ; retrospective studies ; therapeutics ; Tumors</subject><ispartof>Journal of cancer research and clinical oncology, 2023-07, Vol.149 (7), p.2783-2791</ispartof><rights>The Author(s) 2022</rights><rights>2022. The Author(s).</rights><rights>The Author(s) 2022. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c508t-d81d52e6fdaf9780b8cee21eab7e62d512565cb0c1781f5c25d5cefb468a6ec3</citedby><cites>FETCH-LOGICAL-c508t-d81d52e6fdaf9780b8cee21eab7e62d512565cb0c1781f5c25d5cefb468a6ec3</cites><orcidid>0000-0002-6000-2898</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00432-022-04138-3$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00432-022-04138-3$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35779106$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Leccisotti, Lucia</creatorcontrib><creatorcontrib>Maccora, Daria</creatorcontrib><creatorcontrib>Malafronte, Rosalia</creatorcontrib><creatorcontrib>D’Alò, Francesco</creatorcontrib><creatorcontrib>Maiolo, Elena</creatorcontrib><creatorcontrib>Annunziata, Salvatore</creatorcontrib><creatorcontrib>Rufini, Vittoria</creatorcontrib><creatorcontrib>Giordano, Alessandro</creatorcontrib><creatorcontrib>Hohaus, Stefan</creatorcontrib><title>Predicting time to treatment in follicular lymphoma on watchful waiting using baseline metabolic tumour burden</title><title>Journal of cancer research and clinical oncology</title><addtitle>J Cancer Res Clin Oncol</addtitle><addtitle>J Cancer Res Clin Oncol</addtitle><description>Purpose
Asymptomatic patients with follicular lymphoma (FL) and a low tumour burden can be followed without initial therapy, a strategy called watchful waiting (WW). Prediction of the time to treatment (TTT) is still a challenge. We investigated the prognostic value of baseline total metabolic tumour volume (TMTV) and whole-body total lesion glycolysis (WB-TLG) to predict TTT in patients with FL on WW.
Methods
We conducted a retrospective study of 54 patients with FL (grade 1–3a) diagnosed between June 2013 and December 2019, staged with FDG PET/CT, and managed on WW. Median age was 62 years (range 34–85), stage was advanced (III–IV) in 57%, and FLIPI score was intermediate to high (≥ 2) in 52% of the patients.
Results
The median TMTV and WB-TLG were 7.1 and 43.3, respectively. With a median follow-up of 59 months, 41% of patients started immuno-chemotherapy. The optimal cut-points to identify patients with TTT within 24 months were 14 for TMTV (AUC 0.70; 95% CI 51–88) and 64 for WB-TLG (AUC 0.71; 95% CI 52–89) (
p
< 0.005). The probability of not having started treatment within 24 months was 87% for TMTV < 14 and 53% for TMTV ≥ 14 (
p
< 0.005). TMTV was independent of the FLIPI score for TTT prediction. Patients with both FLIPI ≥ 2 and TMTV ≥ 14 had only an 18% probability of not having started treatment at 36 months, while this probability was 75% in patients with TMTV < 14.
Conclusion
Metabolic tumour volume parameters may add information to clinical scores to better predict TTT and better stratify patients for interventional studies.</description><subject>Cancer Research</subject><subject>Chemotherapy</subject><subject>Glycolysis</subject><subject>Hematology</subject><subject>Internal Medicine</subject><subject>Lymphoma</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Metabolism</subject><subject>Oncology</subject><subject>Patients</subject><subject>Positron emission tomography</subject><subject>prediction</subject><subject>probability</subject><subject>retrospective studies</subject><subject>therapeutics</subject><subject>Tumors</subject><issn>0171-5216</issn><issn>1432-1335</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkcluFDEQhlsIRELgBTggS1y4NLi8teeEUMQmRYJD7pbbXT3jyG0Ptpsob48nE8JygIPX-v6yq_6uew70NVA6vCmUCs56ytoQwHXPH3SncLgCzuXD7pTCAL1koE66J6Vc0XaWA3vcnXA5DBug6rSLXzNO3lUft6T6BUlNpGa0dcFYiY9kTiF4twabSbhZ9ru0WJIiubbV7eY1tI2_Fa_lMI-2YPARyYLVjqkpSV2XtGYyrnnC-LR7NNtQ8NndetZdfnh_ef6pv_jy8fP5u4veSaprP2mYJEM1T3beDJqO2iEyQDsOqNgkgUkl3UgdDBpm6ZicpMN5FEpbhY6fdW-PaffruODkWi3ZBrPPfrH5xiTrzZ-R6Hdmm74boByEFkPL8OouQ07fVizVLL44DMFGTGsxnAoqBKNK_BdlSgu6UaBoQ1_-hV613sTWCcM0B6018E2j2JFyOZWScb7_OFBzcN4cnTfNeXPrvOFN9OL3ku8lP61uAD8CpYXiFvOvt_-R9gcL17wh</recordid><startdate>20230701</startdate><enddate>20230701</enddate><creator>Leccisotti, Lucia</creator><creator>Maccora, Daria</creator><creator>Malafronte, Rosalia</creator><creator>D’Alò, Francesco</creator><creator>Maiolo, Elena</creator><creator>Annunziata, Salvatore</creator><creator>Rufini, Vittoria</creator><creator>Giordano, Alessandro</creator><creator>Hohaus, Stefan</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>7S9</scope><scope>L.6</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6000-2898</orcidid></search><sort><creationdate>20230701</creationdate><title>Predicting time to treatment in follicular lymphoma on watchful waiting using baseline metabolic tumour burden</title><author>Leccisotti, Lucia ; 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Asymptomatic patients with follicular lymphoma (FL) and a low tumour burden can be followed without initial therapy, a strategy called watchful waiting (WW). Prediction of the time to treatment (TTT) is still a challenge. We investigated the prognostic value of baseline total metabolic tumour volume (TMTV) and whole-body total lesion glycolysis (WB-TLG) to predict TTT in patients with FL on WW.
Methods
We conducted a retrospective study of 54 patients with FL (grade 1–3a) diagnosed between June 2013 and December 2019, staged with FDG PET/CT, and managed on WW. Median age was 62 years (range 34–85), stage was advanced (III–IV) in 57%, and FLIPI score was intermediate to high (≥ 2) in 52% of the patients.
Results
The median TMTV and WB-TLG were 7.1 and 43.3, respectively. With a median follow-up of 59 months, 41% of patients started immuno-chemotherapy. The optimal cut-points to identify patients with TTT within 24 months were 14 for TMTV (AUC 0.70; 95% CI 51–88) and 64 for WB-TLG (AUC 0.71; 95% CI 52–89) (
p
< 0.005). The probability of not having started treatment within 24 months was 87% for TMTV < 14 and 53% for TMTV ≥ 14 (
p
< 0.005). TMTV was independent of the FLIPI score for TTT prediction. Patients with both FLIPI ≥ 2 and TMTV ≥ 14 had only an 18% probability of not having started treatment at 36 months, while this probability was 75% in patients with TMTV < 14.
Conclusion
Metabolic tumour volume parameters may add information to clinical scores to better predict TTT and better stratify patients for interventional studies.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35779106</pmid><doi>10.1007/s00432-022-04138-3</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-6000-2898</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Cancer Research Chemotherapy Glycolysis Hematology Internal Medicine Lymphoma Medicine Medicine & Public Health Metabolism Oncology Patients Positron emission tomography prediction probability retrospective studies therapeutics Tumors |
| title | Predicting time to treatment in follicular lymphoma on watchful waiting using baseline metabolic tumour burden |
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