Prognostic importance of the standardized uptake value on ^{18}F-fluoro-2-deoxy-glucosepositron emission tomography scan in nonsmall-cell lung cancer : an analysis of 125 cases

Vansteenkiste, Johan F.; Stroobants, Sigrid G.; Dupont, Patrick J.; Leyn, De, Paul R.; Verbeken, Erik K.; Deneffe, Georges J.; Mortelmans, Luc A.; Demedts, Maurits G.

doi:doi:10.1200/JCO.1999.17.10.3201

Publication

Title

Prognostic importance of the standardized uptake value on $^{18}F$ -fluoro-2-deoxy-glucosepositron emission tomography scan in nonsmall-cell lung cancer : an analysis of 125 cases

Author

Vansteenkiste, Johan F.

Stroobants, Sigrid G.

Abstract

PURPOSE: The amount of radio-labeled 18F-fluoro-2-deoxy-glucose (FDG) uptake, a measurement of the increased glucose metabolism of nonsmall-cell lung cancer (NSCLC) cells, has recently been correlated with proliferation capacity. The Standardized Uptake Value (SUV), a semi-quantitative measurement of FDG uptake on positron emission tomography (PET) scan, could thus be of prognostic significance. PATIENTS AND METHODS: We analyzed the follow-up of 125 potentially operable NSCLC patients, previously included in three of our prospective PET protocols. Performance status, maximal tumor diameter, tumor-cell type, SUV, and final staging were analyzed for their possible association with survival. RESULTS: Sixty-five patients had stage I or II NSCLC, 37 had stage IIIA, and 23 had stage IIIB. Treatment was complete resection in 91 cases. In a univariate analysis, performance status (P = .002), stage (P = .001), tumor diameter (P = .06), tumor-cell type (P = .03), and SUV greater than 7 (P = .001) were correlated with survival. For SUV, group dichotomy with a cut-off SUV of 7 had the best discriminative value for prognosis, both in the total and surgical cohort. A multivariate Cox analysis identified performance status (P = .02), stage (P = .01), and SUV (P = .007) as important for the prognosis. In the surgical group, patients with a resected tumor less than 3 cm had an expected 2-year survival of 86%, if the SUV was below 7, and 60%, if above 7. Nearly all resected tumors larger than 3 cm had SUV's greater than 7 and an expected 2-year survival of 43%. CONCLUSION: We conclude that the FDG uptake in primary NSCLC on PET has an important prognostic value and could be complementary to other well-known factors in the decision on adjuvant treatment protocols.

Language

English

Source (journal)

Journal of clinical oncology. - New York

Publication

New York : 1999

ISSN

0732-183X

Volume/pages

17:10(1999), p. 3201-3206

ISI

000082911800027