Tuberc Respir Dis > Volume 71(6); 2011 > Article
Tuberculosis and Respiratory Diseases 2011;71(6):425-430.
DOI:    Published online December 1, 2011.
Prognostic Value of Preoperative Positron Emission Tomography-Computed Tomography in Surgically Resected Stage I and II Non-Small Cell Lung Cancer.
Sung Heon Song, Jang Won Sohn, Hyun Jung Kwak, Sa Il Kim, Sang Heon Kim, Tae Hyung Kim, Ho Joo Yoon, Dong Ho Shin, Yoon Young Choi, Sung Soo Park
1Division of Pulmonology, Cheju Halla General Hospital, Jeju, Korea.
2Department of Internal Medicine, Hanyang University College of Medicine, Guri, Korea.
3Department of Nuclear Medicine, Hanyang University College of Medicine, Guri, Korea.
High 2-[18F] fluoro-2-deoxy-D-glucose (FDG) uptake on positron emission tomography-computed tomography (PET-CT) is a prognostic factor for poor survival in non-small cell lung cancer (NSCLC), especially in Stage I. We determined whether the high FDG uptake value of a primary tumor was associated with recurrence and death in patients with resected Stage I and Stage II NSCLC. METHODS: We identified consecutive patients who underwent complete surgical resection for Stage I and II NSCLC between 2006 and 2009, who had preoperative PET-CT, and reviewed clinical records retrospectively. FDG uptake was measured as the maximal standardized uptake value (SUVmax) for body weight. Patients were divided into two groups based on SUVmax: (i) above or (ii) below the cut-off value (SUVmax=5.9) determined by a receiver operating characteristic (ROC) curve. RESULTS: Of 57 patients who were enrolled consecutively, 32 (56%) had Stage I NSCLC and 25 (44%) had Stage II. The 5-year recurrence-free survival (RFS) for patients with high (> or =5.9) and low (<5.9) SUVmax were 31% and 57%, respectively (p=0.014). The 5-year overall survival (OS) rates were 39% and 60%, respectively (p=0.029). In univariate analyses, SUVmax (p=0.014), T staging (p=0.025), and differentiation of tumor tissue (p=0.034) were significantly associated with RFS. But, multivariate analyses did not show that SUVmax was an independently significant factor for RFS (p=0.180). CONCLUSION: High FDG uptake on PET-CT is not an independent prognostic factor for poor outcomes (disease recurrence in patients with resected Stage I and II NSCLC).
Key Words: Carcinoma, Non-Small Cell Lung, Positron-Emission Tomography, Prognosis

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