Metabolic activity of primary tumour on PET/CT has a relationship with survival in stages I‐III small‐cell lung carcinoma

Abstract

IntroductionThere is limited evidence about the prognostic value of FDG‐PET/CT metrics in small cell lung cancer (SCLC) patients staged with TNM staging system.ObjectivesThe aim of this study is to examine the prognostic value of pretreatment FDG‐SUVmax in patients with SCLC staged with 8th TNM staging system.MethodsA total of 344 (292 male) SCLC patients with pretreatment FDG‐ PET/CT were included. One hundred fifty‐three of cases were stages I‐III, 191 were stage IV. SUVmax values were obtained for primary tumour, lymph nodes and metastases. Univariate and multivariate analysis were performed to determine the effect of pretreatment SUVmax, with cut‐off value of median, on progression‐free and overall survival (PFS and OS).ResultsMedian OS and PFS for patients with stages I‐III were 16.50 and 11.00 months, respectively. Median OS and PFS for patients with stage IV were 10.00 and 7.00 months, respectively. SUVmax of the primary tumour (PT), lymph nodes or metastasis were not associated with OS and PFS on univariate analysis. On multivariate analysis, SUVmax‐PT with cut‐off value of 11.60 was found to be an independent prognostic factor for OS in patients with stages I‐III (HR;1.88, 95% CI:1.15‐3.08, P = .012). But the SUVmax‐PT (HR; 1.60, 95% CI: 0.99‐2.60; P = .057) for PFS was found to be a prognostic factor with marginal significance. SUVmax were not significantly associated with OS and PFS in patients with stage IV disease.ConclusionPretreatment SUVmax‐PT (median cut‐off 11.6) may have a prognostic value of OS and PFS in patients with TNM staged I‐III SCLC.

Prognostic Value of 18F–FDG–PET Parameters in Patients with Small Cell Lung Cancer: A Meta-Analysis and Review of Current Literature

“…In five studies, SUV max were independently prognostic for OS [ 18 , 19 , 20 , 21 , 25 ]. No study showed an independent prognostic value for PFS [ 12 , 25 , 32 , 33 ]. Compared with other covariates included in the multivariate analysis, an additional independent or superior prognostic value of SUV max to stage, age, blood lactate dehydrogenase (LDH), sex, and performance status (PS) was sporadic ( Figure 3 a).…”

“…Twelve studies included baseline SUVmax in a multivariate analysis. In five studies, SUVmax were independently prognostic for OS [18][19][20][21]25]. No study showed an independent prognostic value for PFS [12,25,32,33].…”