Open AccessPrognostic value of metabolic variables of [18F]FDG PET/CT in surgically resected stage I lung adenocarcinoma
Author(s) -
Xiaoyi Wang,
Yanfeng Zhao,
Ying Li,
Yikun Yang,
Ning Wu
Publication year - 2017
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000007941
Subject(s) - medicine , standardized uptake value , adenocarcinoma , positron emission tomography , stage (stratigraphy) , nuclear medicine , proportional hazards model , univariate analysis , lung cancer , receiver operating characteristic , nodule (geology) , lung , radiology , multivariate analysis , cancer , paleontology , biology
The objective of this study was to assess the prognostic value of metabolic tumor burden measured by positron emission tomography/computed tomography (PET/CT) in patients with stage I lung adenocarcinoma. We reviewed 127 consecutive patients with pathologically proven stage I lung adenocarcinoma who underwent pretreatment [18F]FDG PET/CT scans in our hospital from 2005 June to 2012 June. The maximum, mean, and peak standardized uptake value (SUV max , SUV mean , and SUV peak ), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and computed tomography volume (CTV) were measured. The Kaplan–Meier and Cox proportional hazards model were used with age, gender, TNM stage, clinical stage, histological grade, nodule type, tumor size, and metabolic parameters to predict progression-free survival (PFS). The cut-off point was determined through receiver-operating characteristic curve. In univariate analysis, the histological grade, nodule type, diameter (cut-off value of 2.0 cm), CTV (6.56 cm 3 ), SUV max (3.25 g/mL), SUV mean (1.58 g/mL), SUV peak (1.84 g/mL), MTV (4.80 cm 3 ), and TLG (10.40) were significantly associated with PFS (all P value < .05). Patients with poorly differentiated adenocarcinoma, solid nodule type, large size, and high metabolic tumor burden were associated with poor prognosis. In multivariate analysis, only histological grade was independent prognostic factors for progression with a P value of .005 (RR, 0.355; 95% CI, 0.173–0.728). Among 5 PET/CT metabolic parameters, only MTV was independent prognostic factors for progression with a P value of .031 (RR, 1.118; 95% CI, 1.010–1.237). Histological grade was an independent predictor for progression in patients with stage I lung adenocarcinoma. Among 5 PET/CT metabolic parameters, only MTV was an independent predictor for progression.