Prognostic Value of Preoperative Positron Emission Tomography-Computed Tomography in Surgically Resected Stage I and II Non-Small Cell Lung Cancer. |
Sung Heon Song, Jang Won Sohn, Hyun Jung Kwak, Sa Il Kim, Sang Heon Kim, Tae Hyung Kim, Ho Joo Yoon, Dong Ho Shin, Yoon Young Choi, Sung Soo Park |
1Division of Pulmonology, Cheju Halla General Hospital, Jeju, Korea. 2Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea. jwsohn@hanyang.ac.kr 3Department of Nuclear Medicine, Hanyang University College of Medicine, Guri, Korea. |
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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). |
Key Words:
Carcinoma, Non-Small Cell Lung, Positron-Emission Tomography, Prognosis |
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