Tuberc Respir Dis.  2011 Dec;71(6):425-430.

Prognostic Value of Preoperative Positron Emission Tomography-Computed Tomography in Surgically Resected Stage I and II Non-Small Cell Lung Cancer

• Song SH
• Sohn JW
• Kwak HJ
• Kim SI
• Kim SH
• Kim TH
• Yoon HJ
• Shin DH
• Choi YY
• Park SS

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 (> or =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).

Keyword

Carcinoma, Non-Small Cell Lung; Positron-Emission Tomography; Prognosis

MeSH Terms

Body Weight
Carcinoma, Non-Small-Cell Lung
Electrons
Humans
Multivariate Analysis
Positron-Emission Tomography
Prognosis
Recurrence
Retrospective Studies
ROC Curve

Figure

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  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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