{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:38:39Z","timestamp":1791412719363,"version":"4.3.3"},"reference-count":33,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"30","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2016,10,20]]},"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p> Identifying patients at high risk of progression and early death among those with high-tumor-burden follicular lymphoma (FL) is unsatisfactory with current prognostic models. This study aimed to determine the prognostic impact of the total metabolic tumor volume (TMTV) measured at baseline with [<jats:sup>18<\/jats:sup>F]fluorodeoxyglucose\/positron emission tomography-computed tomography ([<jats:sup>18<\/jats:sup>F]FDG\/PET-CT) scans and its added value to these models. <\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p> A pooled analysis was performed by using patient data and centrally reviewed baseline PET-CT scans for 185 patients with FL who were receiving immunochemotherapy within three prospective trials. TMTV was computed by using the 41% maximum standardized uptake value thresholding method, and the optimal cutoff for survival prediction was determined. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Median age was 55 years, 92% of patients had stage III to IV disease, 37% had a Follicular Lymphoma International Prognostic Index (FLIPI) score of 3 to 5, and 31% had a FLIPI2 score of 3 to 5. With a median follow-up of 64 months, overall 5-year progression-free survival (PFS) was 55% and overall survival (OS) was 92%. Median TMTV was 297 cm<jats:sup>3<\/jats:sup> (quartile 1 through quartile 3, 135 to 567 cm<jats:sup>3<\/jats:sup>). The optimal cutoff identified was 510 cm<jats:sup>3<\/jats:sup>, with a markedly inferior survival in the 29% of patients with TMTV &gt; 510 cm<jats:sup>3<\/jats:sup>. Five-year PFS was 33% versus 65% (hazard ratio [HR], 2.90; P &lt; .001), and 5-year OS was 85% versus 95% (HR, 3.45; P = .010). On multivariable analysis, TMTV (HR, 2.3; P = .002) and FLIPI2 score (HR, 2.2; P = .002) were independent predictors of PFS. In combination, they identify three risk groups: high TMTV and intermediate-to-high FLIPI2 score with 5-year PFS of 20% (HR, 5.0; P &lt; .001), high TMTV or intermediate-to-high FLIPI2 score with 5-year PFS of 46% (HR, 2.1; P = .007), and low TMTV and low FLIP2 with 5-year PFS of 69%. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> Baseline TMTV is a strong independent predictor of outcome in FL. In combination with FLIPI2 score, it identifies patients at high risk of early progression. It warrants further validation as a biomarker for development of first-line PET-adapted approaches in FL. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.2016.66.9440","type":"journal-article","created":{"date-parts":[[2016,8,23]],"date-time":"2016-08-23T02:49:19Z","timestamp":1471920559000},"page":"3618-3626","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":295,"title":["Baseline Metabolic Tumor Volume Predicts Outcome in High\u2013Tumor-Burden Follicular Lymphoma: A Pooled Analysis of Three Multicenter Studies"],"prefix":"10.1200","volume":"34","author":[{"given":"Michel","family":"Meignan","sequence":"first","affiliation":[{"name":"Michel Meignan, Anne S\u00e9gol\u00e8ne Cottereau, Jehan Dupuis, and Corinne Haioun, Universit\u00e9 Paris-Est Cr\u00e9teil, Cr\u00e9teil; Lo\u00efc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Universit\u00e9 Claude Bernard Lyon 1, Pierre B\u00e9nite; Ren\u00e9-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Herv\u00e9 Tilly, Universit\u00e9 de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne S\u00e9gol\u00e8ne","family":"Cottereau","sequence":"additional","affiliation":[{"name":"Michel Meignan, Anne S\u00e9gol\u00e8ne Cottereau, Jehan Dupuis, and Corinne Haioun, Universit\u00e9 Paris-Est Cr\u00e9teil, Cr\u00e9teil; Lo\u00efc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Universit\u00e9 Claude Bernard Lyon 1, Pierre B\u00e9nite; Ren\u00e9-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Herv\u00e9 Tilly, Universit\u00e9 de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annibale","family":"Versari","sequence":"additional","affiliation":[{"name":"Michel Meignan, Anne S\u00e9gol\u00e8ne Cottereau, Jehan Dupuis, and Corinne Haioun, Universit\u00e9 Paris-Est Cr\u00e9teil, Cr\u00e9teil; Lo\u00efc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Universit\u00e9 Claude Bernard Lyon 1, Pierre B\u00e9nite; Ren\u00e9-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Herv\u00e9 Tilly, Universit\u00e9 de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lo\u00efc","family":"Chartier","sequence":"additional","affiliation":[{"name":"Michel Meignan, Anne S\u00e9gol\u00e8ne Cottereau, Jehan Dupuis, and Corinne Haioun, Universit\u00e9 Paris-Est Cr\u00e9teil, Cr\u00e9teil; Lo\u00efc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Universit\u00e9 Claude Bernard Lyon 1, Pierre B\u00e9nite; Ren\u00e9-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Herv\u00e9 Tilly, Universit\u00e9 de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jehan","family":"Dupuis","sequence":"additional","affiliation":[{"name":"Michel Meignan, Anne S\u00e9gol\u00e8ne Cottereau, Jehan Dupuis, and Corinne Haioun, Universit\u00e9 Paris-Est Cr\u00e9teil, Cr\u00e9teil; Lo\u00efc Chartier, Sami Boussetta, and Julien Dubreuil, Centre Hospitalier Lyon Sud; Gilles Salles, Universit\u00e9 Claude Bernard Lyon 1, Pierre B\u00e9nite; Ren\u00e9-Olivier Casasnovas, Centre Hospitalier Universitaire-Dijon, Dijon; Herv\u00e9 Tilly, Universit\u00e9 de Rouen, Rouen, France; Annibale Versari and Ilaria Grassi, Santa Maria Nuova Hospital, Istituto Di Ricovero e Cura a Carattere Scientifico; Stefano..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Boussetta","sequence":"additional","affiliation":[{"name":"Michel Meignan, Anne S\u00e9gol\u00e8ne Cottereau, Jehan Dupuis, and Corinne Haioun, Universit\u00e9 Paris-Est Cr\u00e9teil, Cr\u00e9teil; 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