Prognostic value of complete remission status at end-of-treatment FDG-PET in R-CHOP-treated diffuse large B-cell lymphoma: systematic review and meta-analysis

Summary This study systematically reviewed and meta‐analysed the prognostic value of complete remission status at end‐of‐treatment 18 F‐fluoro‐2‐deoxy‐ d ‐glucose positron emission tomography ( FDG ‐ PET ) in diffuse large B‐cell lymphoma ( DLBCL ) patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R‐ CHOP ). The systematic PubMed/ MEDLINE search yielded seven suitable studies comprising a total of 737 R‐ CHOP ‐treated DLBCL patients who were in complete remission at end‐of‐treatment FDG ‐ PET . Overall, the methodological quality of included studies was reasonable. The disease relapse rate among all patients with complete remission status according to end‐of‐treatment FDG ‐ PET ranged from 7·0% to 20·0%, with a weighted summary proportion of 13·7%. Five of seven studies reported progression‐free survival ( PFS ) of these patients at various specific time points, i.e., 2‐year PFS ( n = 1), estimated 3‐year PFS ( n = 3) and 5‐year PFS ( n = 1), which was 83%, 85–86·4% and 75%, respectively. Three of seven studies reported overall survival ( OS ) of these patients at various specific time points, i.e., estimated 3‐year OS ( n = 2) and estimated 5‐year OS ( n = 1), which were 90%, 93·6% and 83%, respectively. In conclusion, a non‐negligible proportion of R‐ CHOP ‐treated DLBCL patients who achieve complete remission according to end‐of‐treatment FDG ‐ PET experiences disease relapse during follow‐up.