Journal List > Tuberc Respir Dis > v.71(6) > 1001686

Song, Sohn, Kwak, Kim, Kim, Kim, Yoon, Shin, Choi, and Park: Prognostic Value of Preoperative Positron Emission Tomography-Computed Tomography in Surgically Resected Stage I and II Non-Small Cell Lung Cancer

Abstract

Background

High 2-[18F] fluoro-2-deoxy-D-glucose (FDG) uptake on positron emission tomography-computed tomography (PET-CT) is a prognostic factor for poor survival in non-small cell lung cancer (NSCLC), especially in Stage I. We determined whether the high FDG uptake value of a primary tumor was associated with recurrence and death in patients with resected Stage I and Stage II NSCLC.

Methods

We identified consecutive patients who underwent complete surgical resection for Stage I and II NSCLC between 2006 and 2009, who had preoperative PET-CT, and reviewed clinical records retrospectively. FDG uptake was measured as the maximal standardized uptake value (SUVmax) for body weight. Patients were divided into two groups based on SUVmax: (i) above or (ii) below the cut-off value (SUVmax=5.9) determined by a receiver operating characteristic (ROC) curve.

Results

Of 57 patients who were enrolled consecutively, 32 (56%) had Stage I NSCLC and 25 (44%) had Stage II. The 5-year recurrence-free survival (RFS) for patients with high (≥5.9) and low (<5.9) SUVmax were 31% and 57%, respectively (p=0.014). The 5-year overall survival (OS) rates were 39% and 60%, respectively (p=0.029). In univariate analyses, SUVmax (p=0.014), T staging (p=0.025), and differentiation of tumor tissue (p=0.034) were significantly associated with RFS. But, multivariate analyses did not show that SUVmax was an independently significant factor for RFS (p=0.180).

Conclusion

High FDG uptake on PET-CT is not an independent prognostic factor for poor outcomes (disease recurrence in patients with resected Stage I and II NSCLC).

Figures and Tables

Figure 1
Recurrence-free survival curve showing a significant difference between SUVmax <5.9 and SUVmax ≥5.9 groups (p=0.014). SUVmax: maximum tumor standardized uptake value.
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Figure 2
Overall survival curve showing significant difference between SUVmax <5.9 and SUVmax ≥5.9 groups (p=0.029). SUVmax: maximum tumor standardized uptake value.
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Table 1
Characteristics of resected stage I, II NSCLC subjects, grouped by SUVmax <5.9 or ≥5.9
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SUVmax: maximum tumor standardized uptake value.

Table 2
Univariate analysis for predictors of outcomes in resected stage I, II NSCLC
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RFS: recurrence-free survival; SR: overall survival rate; SUVmax: maximum tumor standardized uptake value.

Table 3
Multivariate Cox models for recurrence analysis
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OR: odds ratio; CI: confidence interval; SUVmax: maximum tumor standardized uptake value.

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