Prognostic Impact of FDG-PET in Surgically Treated Pathological Stage I Lung Adenocarcinoma

Abstract

Purpose: This retrospective study evaluated whether the maximum standardized uptake value (SUVmax) on 18F-deoxyglucose (FDG)-positron emission tomography (PET) could be used to predict the prognosis of patients with pathological stage I adenocarcinoma. Methods: We analyzed 138 consecutive patients with pathological stage IA or IB lung adenocarcinoma except pure bronchioloalveolar carcinoma (BAC) who underwent preoperative FDG-PET imaging and curative resection from January 2005 to October 2010. We analyzed associations between disease-free survival (DFS) and clinicopathological factors. Results: The 5-year DFS rate was 77.7%. Twenty two patients (15.9%) developed recurrence after surgery. Multivariate analysis identified SUVmax and lymphovascular (ly) involvement as the independent prognostic factors for recurrence (p = 0.0255 and p = 0.0333, respectively). We divided the patients into groups according to SUVmax and ly involvement. The 5-year DFS rate was 97.0% in patients with SUVmax ≤2.5 and without ly involvement, 100% with both SUVmax ≤2.5 and ly involvement, 70.2% with SUVmax >2.5 and without ly involvement, and 53.1% with both SUVmax >2.5 and ly involvement. Conclusions: The results of this study suggest that SUVmax and ly involvement could be used to predict the prognosis of patients with pathological stage I adenocarcinoma. The combination of these prognostic factors could also identify high risk groups of recurrence.

Differences in the Prognostic Significance of the SUVmax between Patients with Resected Pulmonary Adenocarcinoma and Squamous Cell Carcinoma

“…Recently, FDG-PET has become a valuable tool for evaluating patients with NSCLC, and many studies have indicated the utility of FDG-PET for evaluating the clinical stage (de Geus-Oei et al, 2007;Al-Jahdali et al, 2012), chemotherapy effect and recurrence (Hoekstra et al, 2005;Al-Jahdali et al, 2012), and also for predicting the prognosis in patients with resected NSCLC (AlSarraf et al, 2008;Higuchi et al, 2014). However, in this study, we demonstrated differences in the prognostic significance of the SUVmax according to the histologic type of NSCLC.…”

F-18 FDG uptake on positron emission tomography as a predictor for lymphovascular invasion in patients with lung adenocarcinoma

“…Our data suggested the SUVmax cutoff value of 2.32 appears to be a valuable index in the detection of tumors with lymphovascular invasion. This cutoff value was comparable with that published in a previous study: Higuchi et al [24] reported that the SUVmax cutoff value of 2.5 could be used to predict for 5-year disease-free survival. Our study had several limitations.…”

Predictive and Prognostic Role of Metabolic Response in Patients With Stage III NSCLC Treated With Neoadjuvant Chemotherapy

“…However, in the literature, there is not much evidence on the role of pretreatment parameters in prediction of response, whereas more data exist regarding prechemotherapy parameters and prediction of prognosis. [29][30][31][32][33] Additionally, we also showed that lymph node uptakes in patients post-treatment, expressed both as absolute values and percentage changes, were significantly different between the 2 groups (responders vs. non-responders). Although most studies in the literature have evaluated the metabolic activity of regional lymph nodes as a prognostic index, Kamel et al 15 showed that less than Metabolic Response in NSCLC After Neoadjuvant Therapy 60% reduction in N2 SUVmax after induction therapy was an independent predictor of residual N2 disease, which is often associated with poor survival outcomes.…”