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Erschienen in: Journal of Cancer Research and Clinical Oncology 4/2019

13.02.2019 | Original Article – Clinical Oncology

Does FDG PET/CT have a role in determining adjuvant chemotherapy in surgical margin-negative stage IA non-small cell lung cancer patients?

verfasst von: Hye Lim Park, Ie Ryung Yoo, Sun Ha Boo, Sonya Youngju Park, Jae Kil Park, Sook Whan Sung, Seok Whan Moon

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 4/2019

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Abstract

Purpose

To evaluate the prognostic value of FDG PET/CT metabolic parameter compared to clinico–pathological risk factors in surgical margin-negative stage IA non-small cell lung cancer (NSCLC) patients.

Methods

167 patients with consecutive FDG PET/CT scans from 2009 to 2015 performed for staging of NSCLC stage IA with plans for curative surgery were retrospectively reviewed. Maximum standardized uptake value (SUVmax) of primary tumor and mean SUV of liver were acquired from PET/CT. Tumor-to-liver SUV ratio (TLR) was calculated. Charts were reviewed to obtain basic patient characteristics (age, sex, smoking history, LDH, histologic subtype) and high-risk factors for adjuvant chemotherapy (tumor size, poorly differentiation, vascular invasion, and sub-lobar resection). Patients were dichotomized into two groups using optimal cut-off from receiver operating characteristic curve analysis of TLR to predict recurrence. Statistical analysis was done using Cox regression analysis and Kaplan–Meier method. Factors with P < 0.2 in univariate analysis were included in multivariate analysis.

Results

Recurrence rate was 12.6% (21/167). Median disease-free survival (DFS) was 47.2 months while 2-year and 5-year DFS rates were 93% and 86%, respectively. The optimal cut-off for TLR was 2.3. In univariate analysis, P value of sex, vascular invasion, and TLR were less than 0.2. In multivariable analysis, high TLR was the only factor that showed significant association with tumor recurrence (hazard ratio 3.795, P = 0.0048).

Conclusions

TLR was an independent prognostic factor for recurrence and TLR could be an important risk factor to be considered in decision-making for adjuvant chemotherapy, even for those with stage IA NSCLC.
Literatur
Zurück zum Zitat Anwar H, Vogl TJ, Abougabal MA, Grünwald F, Kleine P, Elrefaie S, Nour-Eldin NA (2018) The value of different 18F-FDG PET/CT baseline parameters in risk stratification of stage I surgical NSCLC patients. Ann Nucl Med 32:687–694CrossRefPubMed Anwar H, Vogl TJ, Abougabal MA, Grünwald F, Kleine P, Elrefaie S, Nour-Eldin NA (2018) The value of different 18F-FDG PET/CT baseline parameters in risk stratification of stage I surgical NSCLC patients. Ann Nucl Med 32:687–694CrossRefPubMed
Zurück zum Zitat Horn L, Sandler AB, Putnam JB Jr, Johnson DH (2007) The rationale for adjuvant chemotherapy in stage I non-small cell lung cancer. J Thorac Oncol 2:377–383CrossRefPubMed Horn L, Sandler AB, Putnam JB Jr, Johnson DH (2007) The rationale for adjuvant chemotherapy in stage I non-small cell lung cancer. J Thorac Oncol 2:377–383CrossRefPubMed
Zurück zum Zitat Jeong E, Hyun SH, Moon SH, Cho YS, Kim BT, Lee KH (2017) Relation between tumor FDG uptake and hematologic prognostic indicators in stage I lung cancer patients following curative resection. Medicine (Baltimore) 96:e5935CrossRef Jeong E, Hyun SH, Moon SH, Cho YS, Kim BT, Lee KH (2017) Relation between tumor FDG uptake and hematologic prognostic indicators in stage I lung cancer patients following curative resection. Medicine (Baltimore) 96:e5935CrossRef
Zurück zum Zitat Kang YK, Song YS, Cho S, Jheon S, Lee WW, Kim K, Kim SE (2018) Prognostic stratification model for patients with stage I non-small cell lung cancer adenocarcinoma treated with surgical resection without adjuvant therapies using metabolic features measured on F-18 FDG PET and postoperative pathologic factors. Lung Cancer 119:1–6CrossRefPubMed Kang YK, Song YS, Cho S, Jheon S, Lee WW, Kim K, Kim SE (2018) Prognostic stratification model for patients with stage I non-small cell lung cancer adenocarcinoma treated with surgical resection without adjuvant therapies using metabolic features measured on F-18 FDG PET and postoperative pathologic factors. Lung Cancer 119:1–6CrossRefPubMed
Zurück zum Zitat Ko KH, Hsu HH, Huang TW, Gao HW, Cheng CY, Hsu YC, Chang WC, Chu CM, Chen JH, Lee SC (2015) Predictive value of 18F-FDG PET and CT morphologic features for recurrence in pathological stage IA non-small cell lung cancer. Medicine (Baltimore) 94:e434CrossRef Ko KH, Hsu HH, Huang TW, Gao HW, Cheng CY, Hsu YC, Chang WC, Chu CM, Chen JH, Lee SC (2015) Predictive value of 18F-FDG PET and CT morphologic features for recurrence in pathological stage IA non-small cell lung cancer. Medicine (Baltimore) 94:e434CrossRef
Zurück zum Zitat Kurtipek E, Cayci M, Düzgün N, Esme H, Terzi Y, Bakdik S, Aygün MS, Unlü Y, Burnik C, Bekci TT (2015) (18)F-FDG PET/CT mean SUV and metabolic tumor volume for mean survival time in non-small cell lung cancer. Clin Nucl Med 40:459–463CrossRefPubMed Kurtipek E, Cayci M, Düzgün N, Esme H, Terzi Y, Bakdik S, Aygün MS, Unlü Y, Burnik C, Bekci TT (2015) (18)F-FDG PET/CT mean SUV and metabolic tumor volume for mean survival time in non-small cell lung cancer. Clin Nucl Med 40:459–463CrossRefPubMed
Zurück zum Zitat Liu J, Dong M, Sun X, Li W, Xing L, Yu J (2016) Prognostic value of 18F-FDG PET/CT in surgical non-small cell lung cancer: a meta-analysis. PLoS One 11:e0146195CrossRefPubMedPubMedCentral Liu J, Dong M, Sun X, Li W, Xing L, Yu J (2016) Prognostic value of 18F-FDG PET/CT in surgical non-small cell lung cancer: a meta-analysis. PLoS One 11:e0146195CrossRefPubMedPubMedCentral
Zurück zum Zitat Maeda R, Yoshida J, Ishii G, Aokage K, Hishida T, Nishimura M, Nishiwaki Y, Nagai K (2010) Long-term outcome and late recurrence in patients with completely resected stage IA non-small cell lung cancer. J Thorac Oncol 5:1246–1250CrossRefPubMed Maeda R, Yoshida J, Ishii G, Aokage K, Hishida T, Nishimura M, Nishiwaki Y, Nagai K (2010) Long-term outcome and late recurrence in patients with completely resected stage IA non-small cell lung cancer. J Thorac Oncol 5:1246–1250CrossRefPubMed
Zurück zum Zitat Monirul Islam KM, Shostrom V, Kessinger A, Ganti AK (2013) Outcomes following surgical treatment compared to radiation for stage I NSCLC: a SEER database analysis. Lung Cancer 82:90–94CrossRefPubMed Monirul Islam KM, Shostrom V, Kessinger A, Ganti AK (2013) Outcomes following surgical treatment compared to radiation for stage I NSCLC: a SEER database analysis. Lung Cancer 82:90–94CrossRefPubMed
Zurück zum Zitat Paquet N, Albert A, Foidart J, Hustinx R (2004) Within-patient variability of (18)F-FDG: standardized uptake values in normal tissues. J Nucl Med 45:784–788PubMed Paquet N, Albert A, Foidart J, Hustinx R (2004) Within-patient variability of (18)F-FDG: standardized uptake values in normal tissues. J Nucl Med 45:784–788PubMed
Zurück zum Zitat Park SY, Cho A, Yu WS, Lee CY, Lee JG, Kim DJ, Chung KY (2015) Prognostic value of total lesion glycolysis by 18F-FDG PET/CT in surgically resected stage IA non-small cell lung cancer. J Nucl Med 56:45–49CrossRefPubMed Park SY, Cho A, Yu WS, Lee CY, Lee JG, Kim DJ, Chung KY (2015) Prognostic value of total lesion glycolysis by 18F-FDG PET/CT in surgically resected stage IA non-small cell lung cancer. J Nucl Med 56:45–49CrossRefPubMed
Zurück zum Zitat Shin S, Pak K, Kim IJ, Kim BS, Kim SJ (2017) Prognostic value of tumor-to-blood standardized uptake ratio in patients with resectable non-small-cell lung cancer. Nucl Med Mol Imaging 51:233–239CrossRefPubMed Shin S, Pak K, Kim IJ, Kim BS, Kim SJ (2017) Prognostic value of tumor-to-blood standardized uptake ratio in patients with resectable non-small-cell lung cancer. Nucl Med Mol Imaging 51:233–239CrossRefPubMed
Zurück zum Zitat Song IH, Yeom SW, Heo S, Choi WS, Yang HC, Jheon S, Kim K, Cho S (2014) Prognostic factors for post-recurrence survival in patients with completely resected stage I non-small-cell lung cancer. Eur J Cardiothorac Surg 45:262–267CrossRefPubMed Song IH, Yeom SW, Heo S, Choi WS, Yang HC, Jheon S, Kim K, Cho S (2014) Prognostic factors for post-recurrence survival in patients with completely resected stage I non-small-cell lung cancer. Eur J Cardiothorac Surg 45:262–267CrossRefPubMed
Zurück zum Zitat Vesselle H, Salskov A, Turcotte E, Wiens L, Schmidt R, Jordan CD, Vallieres E, Wood DE (2008) Relationship between non-small cell lung cancer FDG uptake at PET, tumor histology, and Ki-67 proliferation index. J Thorac Oncol 3:971–978CrossRefPubMed Vesselle H, Salskov A, Turcotte E, Wiens L, Schmidt R, Jordan CD, Vallieres E, Wood DE (2008) Relationship between non-small cell lung cancer FDG uptake at PET, tumor histology, and Ki-67 proliferation index. J Thorac Oncol 3:971–978CrossRefPubMed
Zurück zum Zitat Vu CC, Matthews R, Kim B, Franceschi D, Bilfinger TV, Moore WH (2013) 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 34:959–963CrossRefPubMed Vu CC, Matthews R, Kim B, Franceschi D, Bilfinger TV, Moore WH (2013) 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 34:959–963CrossRefPubMed
Zurück zum Zitat Zhang H, Wroblewski K, Liao S, Kampalath R, Penney BC, Zhang Y, Pu Y (2013) Prognostic value of metabolic tumor burden from (18)F-FDG PET in surgical patients with non-small-cell lung cancer. Acad Radiol 20:32–40CrossRefPubMed Zhang H, Wroblewski K, Liao S, Kampalath R, Penney BC, Zhang Y, Pu Y (2013) Prognostic value of metabolic tumor burden from (18)F-FDG PET in surgical patients with non-small-cell lung cancer. Acad Radiol 20:32–40CrossRefPubMed
Metadaten
Titel
Does FDG PET/CT have a role in determining adjuvant chemotherapy in surgical margin-negative stage IA non-small cell lung cancer patients?
verfasst von
Hye Lim Park
Ie Ryung Yoo
Sun Ha Boo
Sonya Youngju Park
Jae Kil Park
Sook Whan Sung
Seok Whan Moon
Publikationsdatum
13.02.2019
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Cancer Research and Clinical Oncology / Ausgabe 4/2019
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-019-02858-7

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