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Prognostic role of baseline 18F-FDG pet/CT in stage I and stage ii non-small cell lung cancer

Published:December 01, 2022DOI:https://doi.org/10.1016/j.clinimag.2022.11.014

      Highlights

      • We demonstrated the prognostic role of 18F-FDG PET/CT in stage I and II NSCLC
      • SUVmax, SUVmean, SUVlbm, SUVbsa and S-L were demonstrated as independent prognostic factors for OS and DSS.
      • 18F-FDG PET/CT semiquantitative parameters were independent prognosticators for DSS in patients treated with surgery and adjuvant therapy.

      Abstract

      Objective

      investigate the prognostic role of baseline 18F-FDG PET/CT in stage I-II NSCLC.

      Material and methods

      296 patients were included. Clinicopathological features and PET/CT semiquantitative parameters [standardized uptake value (SUV) body weight max (SUVmax), SUV body weight mean (SUVmean), SUV lean body mass (SUVlbm), SUV body surface area (SUVbsa), metabolic tumor volume (MTV), total lesion glycolysis (TLG), ratio SUVmax/liver (S-L) and ratio SUVmax/blood-pool (S-BP) were extracted]. Anova and Kruskall-Wallis tests were used to assess the relationship between these parameters. Kaplan-Meier, univariate and multivariate analysis were performed to search independent prognostic factors for progression free (PFS), overall survival (OS) and disease specific survival (DSS).

      Results

      Correlation between PET/CT semiquantitative parameters and histology, stage, size, grading and presence of nodal metastasis were reported. Mean PFS was 28.1 months, relapse/progression of disease occurred in 85 patients (28.7%). Mean OS was 33.3 months, death occurred in 43 patients (14.5%); specific death by NSCLC occurred in 26 subjects (8.8%). Kaplan-Meier analyses revealed most of semiquantitative parameters as predictive for PFS, OS and DSS. For DSS, this was confirmed when dividing between patients with surgery and surgery with other therapies. SUVmax, SUVmean, SUVlbm, SUVbsa and S-L revealed to be independent prognosticators for OS and DSS. S-BP was an independent prognosticator for DSS. SUVmax, SUVmean, SUVlbm, S-L and S-BP were confirmed as independent prognosticators for DSS in the group of patients treated with surgery and subsequent adjuvant therapy.

      Conclusion

      Baseline 18F-FDG PET/CT semiquantitative parameters are confirmed as prognostic tools for stage I-II NSCLC, in particular for DSS.

      Keywords

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      References

        • Park S.Y.
        • Cho A.
        • Yu W.S.
        • Lee C.Y.
        • Lee J.G.
        • Kim D.J.
        • Chung K.Y.
        Prognostic value of total lesion glycolysis by 18F-FDG PET/CT in surgically resected stage IA non-small cell lung cancer.
        J Nucl Med. 2015 Jan; 56: 45-49
        • Bray F.
        • Ferlay J.
        • Soerjomataram I.
        • Siegel R.L.
        • Torre L.A.
        • Jemal A.
        Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.
        CA Cancer J Clin. 2018 Nov; 68: 394-424
        • Rami-Porta R.
        • Bolejack V.
        • Giroux D.J.
        • Chansky K.
        • Crowley J.
        • Asamura H.
        • Goldstraw P.
        • International Association for the Study of Lung Cancer Staging and Prognostic Factors Committee
        • Advisory Board Members and Participating Institutions
        The IASLC lung cancer staging project: the new database to inform the eighth edition of the TNM classification of lung cancer.
        J Thorac Oncol. 2014; 9 (Nov): 1618-1624
        • Duma N.
        • Santana-Davila R.
        • Molina J.R.
        Non-small cell lung cancer: epidemiology, screening, diagnosis, and treatment.
        Mayo Clin Proc. 2019 Aug; 94: 1623-1640
        • Goldstraw P.
        • Chansky K.
        • Crowley J.
        • et al.
        The IASLC lung cancer staging project: proposals for revision of the TNM stage groupings in the forthcoming (eighth) edition of the TNM classification for lung cancer.
        J Thorac Oncol. 2016; 11: 39-51
        • Kocher F.
        • Hilbe W.
        • Seeber A.
        • et al.
        Longitudinal analysis of 2293 NSCLC patients: a comprehensive study from the TYROL registry.
        Lung Cancer. 2015; 87: 193-200
        • Albano D.
        • Gatta R.
        • Marini M.
        • et al.
        Role of 18F-FDG PET/CT radiomics features in the differential diagnosis of solitary pulmonary nodules: diagnostic accuracy and comparison between two different PET/CT scanners.
        J Clin Med. 2021; 10 (Published 2021 Oct 29): 5064
        • Martini N.
        • Bains M.S.
        • Burt M.E.
        • et al.
        Incidence and local recurrence and second primary tumors in resected stage I lung cancer.
        J Thorac Cardiovasc Surg. 1995; 109: 120-129
        • Goya T.
        • Asamura H.
        • Yoshimura H.
        • et al.
        Prognosis of 6644 resected non-small cell lung cancers in Japan: a Japanese lung cancer registry study.
        Lung Cancer. 2005; 50: 227-234
        • Harpole Jr., D.H.
        • Herndon 2nd, J.E.
        • Young Jr., W.G.
        • Wolfe W.G.
        • Sabiston Jr., D.C.
        Stage I non-small cell lung cancer: a multivariate analysis of treatment methods and patterns of recurrence.
        Cancer. 1995; 76: 787-796
        • Williams D.E.
        • Pairolero P.C.
        • Davis C.S.
        • et al.
        Survival of patients surgically treated for stage I lung cancer.
        J Thorac Cardiovasc Surg. 1981; 82: 70-76
        • Wisnivesky J.P.
        • Henschke C.
        • McGinn T.
        • Iannuzzi M.C.
        Prognosis of stage II non small cell lung cancer according to tumor and nodal status at diagnosis.
        Lung Cancer. 2005; 49: 181-186
        • Al-Sarraf N.
        • Gately K.
        • Lucey J.
        • et al.
        Clinical implication and prognostic significance of standardised uptake value of primary non-small cell lung cancer on positron emission tomography: analysis of 176 cases.
        Eur J Cardiothorac Surg Off J Eur Assoc Cardiothorac Surg. 2008; 34: 892-897
        • Gallamini A.
        • Zwarthoed C.
        • Borra A.
        Positron emission tomography (PET) in oncology.
        Cancers. 2014; 6: 1821-1889
        • Wen W.
        • Piao Y.
        • Xu D.
        • Li X.
        Prognostic value of MTV and TLG of 18F-FDG PET in patients with stage I and II non-small-cell lung cancer: a meta-analysis.
        Contrast Media Mol Imaging. 2021; (Published 2021 Nov 22)7528971
        • Boellaard R.
        • Delgado-Bolton R.
        • Oyen W.J.
        • Giammarile F.
        • Tatsch K.
        • Eschner W.
        • et al.
        FDG PET/CT: EANM procedure guidelines for tumour imaging: version 2.0.
        Eur J Nucl Med Mol Imaging. 2015; 42: 328-354
        • Schuurbiers O.C.
        • Meijer T.W.
        • Kaanders J.H.
        • Looijen-Salamon M.G.
        • de Geus-Oei L.F.
        • van der Drift M.A.
        • van der Heijden E.H.
        • Oyen W.J.
        • Visser E.P.
        • Span P.N.
        • Bussink J.
        Glucose metabolism in NSCLC is histology-specific and diverges the prognostic potential of 18FDG-PET for adenocarcinoma and squamous cell carcinoma.
        J Thorac Oncol. 2014 Oct; 9: 1485-1493
        • Hanin F.X.
        • Lonneux M.
        • Cornet J.
        • Noirhomme P.
        • Coulon C.
        • Distexhe J.
        • et al.
        Prognostic value of FDG uptake in early stage non-small cell lung cancer.
        Eur J Cardiothorac Surg. 2008; 33: 819-823
        • Kim Y.S.
        • Kim S.J.
        • Kim Y.K.
        • Kim I.J.
        • Kim Y.D.
        • Lee M.K.
        Prediction of survival and cancer recurrence using F-18 FDG PET/CT in patients with surgically resected early stage (Stage I and II) non-small cell lung cancer.
        Neoplasma. 2011; 58: 245-250
        • Abelson J.A.
        • Murphy J.D.
        • Trakul N.
        • Bazan J.G.
        • Maxim P.G.
        • Graves E.E.
        • Quon A.
        • Le Q.T.
        • Diehn M.
        • Loo Jr., B.W.
        Metabolic imaging metrics correlate with survival in early stage lung cancer treated with stereotactic ablative radiotherapy.
        Lung Cancer. 2012 Dec; 78: 219-224
        • Vu C.C.
        • Matthews R.
        • Kim B.
        • Franceschi D.
        • Bilfinger T.V.
        • Moore W.H.
        Prognostic value of metabolic tumor volume and total lesion glycolysis from 18F-FDG PET/CT in patients undergoing stereotactic body radiation therapy for stage I non-small-cell lung cancer.
        Nucl Med Commun. 2013 Oct; 34: 959-963
        • Shrestha S.
        • Higuchi T.
        • Shirai K.
        • Tokue A.
        • Shrestha S.
        • Saitoh J.I.
        • Hirasawa H.
        • Ohno T.
        • Nakano T.
        • Tsushima Y.
        Prognostic significance of semi-quantitative FDG-PET parameters in stage I non-small cell lung cancer treated with carbon-ion radiotherapy.
        Eur J Nucl Med Mol Imaging. 2020 May; 47: 1220-1227
        • Lin Y.
        • Lin W.Y.
        • Kao C.H.
        • Yen K.Y.
        • Chen S.W.
        • Yeh J.J.
        Prognostic value of preoperative metabolic tumor volumes on PET-CT in predicting disease-free survival of patients with stage I non-small cell lung cancer.
        Anticancer Res. 2012 Nov; 32: 5087-5091
        • Kim S.J.
        • Kim Y.K.
        • Kim I.J.
        • Kim Y.D.
        • Lee M.K.
        Limited prognostic value of dual time point F-18 FDG PET/CT in patients with early stage (stage I & II) non-small cell lung cancer (NSCLC).
        Radiother Oncol. 2011 Jan; 98: 105-108
        • Hyun S.H.
        • Choi J.Y.
        • Kim K.
        • Kim J.
        • Shim Y.M.
        • Um S.W.
        • Kim H.
        • Lee K.H.
        • Kim B.T.
        Volume-based parameters of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography improve outcome prediction in early-stage non-small cell lung cancer after surgical resection.
        Ann Surg. 2013 Feb; 257: 364-370
        • Melloni G.
        • Gajate A.M.
        • Sestini S.
        • Gallivanone F.
        • Bandiera A.
        • Landoni C.
        • Muriana P.
        • Gianolli L.
        • Zannini P.
        New positron emission tomography derived parameters as predictive factors for recurrence in resected stage I non-small cell lung cancer.
        Eur J Surg Oncol. 2013 Nov; 39: 1254-1261
        • Anwar H.
        • Vogl T.J.
        • Abougabal M.A.
        • Grünwald F.
        • Kleine P.
        • Elrefaie S.
        • Nour-Eldin N.A.
        The value of different 18F-FDG PET/CT baseline parameters in risk stratification of stage I surgical NSCLC patients.
        Ann Nucl Med. 2018 Dec; 32: 687-694
        • Park S.Y.
        • Cho A.
        • Yu W.S.
        • Lee C.Y.
        • Lee J.G.
        • Kim D.J.
        • Chung K.Y.
        Prognostic value of total lesion glycolysis by 18F-FDG PET/CT in surgically resected stage IA non-small cell lung cancer.
        J Nucl Med. 2015 Jan; 56: 45-49
        • Domachevsky L.
        • Groshar D.
        • Galili R.
        • Saute M.
        • Bernstine H.
        Survival prognostic value of morphological and metabolic variables in patients with stage I and II non-small cell lung cancer.
        Eur Radiol. 2015 Nov; 25: 3361-3367