Revisiting the prognostic value of preoperative 18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET) in early-stage (I & II) non-small cell lung cancers (NSCLC)
Autor: | Govinda Brahmanday, Ching-Yee Oliver Wong, Mohit Agarwal, K. P. Ravikrishnan, Sunil K. Bajaj |
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Rok vydání: | 2009 |
Předmět: |
Adult
Male Fluorine Radioisotopes Lung Neoplasms Survival Pathological staging Standardized uptake value Kaplan-Meier Estimate FDG-Positron Emission Tomography Preoperative care Non-small cell lung cancer Fluorodeoxyglucose F18 Carcinoma Non-Small-Cell Lung Preoperative Care Carcinoma medicine Humans Radiology Nuclear Medicine and imaging Aged Neoplasm Staging Proportional Hazards Models Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Deoxyglucose General Medicine Middle Aged Prognosis medicine.disease Primary tumor SUV ROC Curve Radiology Nuclear Medicine and imaging Positron emission tomography Positron-Emission Tomography Original Article Female Radiopharmaceuticals Nuclear medicine business 18F-FDG PET Follow-Up Studies |
Zdroj: | European Journal of Nuclear Medicine and Molecular Imaging |
ISSN: | 1619-7089 1619-7070 |
DOI: | 10.1007/s00259-009-1291-x |
Popis: | Purpose The aims were to determine if the maximum standardized uptake value (SUVmax) of the primary tumor as determined by preoperative 18F-fluoro-2-deoxyglucose (18F-FDG) positron emission tomography (PET) is an independent predictor of overall survival and to assess its prognostic value after stratification according to pathological staging. Methods A retrospective clinicopathologic review of 363 patients who had a preoperative 18F-FDG PET done before undergoing attempted curative resection for early-stage (I & II) non-small cell lung cancer (NSCLC) was performed. Patients who had received any adjuvant or neoadjuvant chemotherapy or radiation therapy were excluded. The primary outcome measure was duration of overall survival. Receiver-operating characteristic (ROC) curves were plotted to find out the optimal cutoff values of SUVmax yielding the maximal sensitivity plus specificity for predicting the overall survival. Survival curves stratified by median SUVmax and optimal cutoff SUVmax were estimated by the Kaplan-Meier method and statistical differences were assessed using the log-rank test. Multivariate proportional hazards (Cox) regression analyses were applied to test the SUVmax’s independency of other prognostic factors for the prediction of overall survival. Results The median duration of follow-up was 981 days (2.7 years). The median SUVmax was 5.9 for all subjects, 4.5 for stage IA, 8.4 for stage IB, and 10.9 for stage IIB. The optimal cutoff SUVmax was 8.2 for all subjects. No optimal cutoff could be established for specific stages. In univariate analyses, each doubling of SUVmax [i.e., each log (base 2) unit increase in SUVmax] was associated with a 1.28-fold [95% confidence interval (CI): 1.03–1.59, p = 0.029] increase in hazard of death. Univariate analyses did not show any significant difference in survival by SUVmax when data were stratified according to pathological stage (p = 0.119, p = 0.818, and p = 0.882 for stages IA, IB, and IIB, respectively). Multivariate analyses demonstrated that SUVmax was not an independent predictor of overall survival (p > 0.05). Conclusion Each doubling of SUVmax as determined by preoperative PET is associated with a 1.28-fold increase in hazard of death in early-stage (I & II) NSCLC. Preoperative SUVmax is not an independent predictor of overall survival. |
Databáze: | OpenAIRE |
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