Objectives: Non small-cell lung cancer (NSCLC) has a poor prognosis even for early stages of the disease (stage I and II). Adjuvant chemotherapy is currently advised only for stage II tumors. We tested whether tumor FDG uptake could predict survival in resected stage I & II NSCLC.
Methods: Retrospective study of 97 pts with NSCLC whose staging included. 18F-FDG-PET. Histopathological stage was either Stage I (n=76) or Stage II (n=21). FDG uptake was measured as maximal SUVbw (SUVmax). Mean follow-up was 45±30 mo (1-142 mo). Overall and disease free-survival were recorded.
Results: SUVmax were higher for Stage II than for Stage I (10.5±4.5 vs. 8.5±5, p=0.04). Mean tumor volumes were equivalent for both stages (33 cm3), excluding a partial volume effect. Median SUVmax was 7.8. Patients were dichotomized according to a threshold of 7.8. Mean actuarial survival was significantly reduced for patients with higher tumor uptake : 127 mo if SUVmax <7.8 and 69 mo if SUVmax ³7.8 (p=0.0003). For Stage I tumors (n=76), high FDG uptake was associated to reduced survival : 127 mo if SUVmax <7.8 and 69 mo if SUVmax ³7.8 (p=0.0017). For Stage II tumors (n=21), no statistical difference was observed: 72 mo vs. 40 mo for SUVmax <7.8 and for SUVmax ³7.8, respectively (p=0.11).
Conclusions: FDG uptake is a prognostic indicator for survival in NSCLC. However, this prognostic value applies only to Stage I tumors. This study suggests that a subgroup of patients with stage I disease (FDG uptake, SUVmax ³7.8) might therefore benefit from adjuvant chemotherapy
Prognostic value of FDG uptake in Early Non Small Cell Lung CancerPoncelet AJ, Hanin F-X, Noirhomme Ph, Coulon C, Distexhe J, Lonneux M
Cliniques Universitaires Saint-Luc, Bruxelles |