The prognostic significance of FDG-PET in advanced non-small cell lung cancer

Jung, Hyun Young; Jang, Saet Byul; Jung, Hye Ryun; Lee, Sun Ah; Bae, Sung Hwa; Hyun, Dae Sung; Lee, Sang Chae; Ryoo, Hun Mo

Abstract

BACKGROUND/AIMS: Lung cancer is the leading cause of cancer-related death in Korea. Non-small cell lung cancer (NSCLC) comprises 80~85% of lung cancer. Positron emission tomography with [18F]fluorodeoxyglucose (FDG-PET) shows various levels of FDG uptake for patients with NSCLC. This study determined whether the standardized uptake value (SUV) of FDG uptake by PET is a prognostic factor for advanced NSCLC.
METHODS
FDG-PET was performed in 59 patients with stage IIIb and IV NSCLC. The SUV was calculated for each patient. Overall survival (OS) and time to progression were calculated using the Kaplan-Meier method and evaluated with the log-rank test. The prognostic significance was assessed using univariate and multivariate analyses.
RESULTS
A cutoff of 7 for the SUV gave the best criminative value. In the univariate analysis, performance status (p=0.02) and SUV (p=0.03) were significant predictors of OS. The patients with low SUVs (< or =7) had significantly better times to progression than those with high SUVs (>7, p=0.04). A multivariate Cox analysis identified performance status and the SUV as important for the prognosis.
CONCLUSIONS
These results suggest that SUV is a significant prognostic factor in patients with advanced non-small cell lung cancer.