Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Prognostic Value of Preoperative Positron Emission Tomography-Computed Tomography in Surgically Resected Stage I and II Non-Small Cell Lung Cancer

I, II병기 비소세포폐암의 예후에 대한 수술 전 양전자방출 컴퓨터 단층촬영기의 임상적 의의

  • Song, Sung-Heon (Division of Pulmonology, Cheju Halla General Hospital) ;
  • Sohn, Jang-Won (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kwak, Hyun-Jung (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Sa-Il (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Sang-Heon (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Kim, Tae-Hyung (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Yoon, Ho-Joo (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Shin, Dong-Ho (Department of Internal Medicine, Hanyang University College of Medicine) ;
  • Choi, Yoon-Young (Department of Nuclear Medicine, Hanyang University College of Medicine) ;
  • Park, Sung-Soo (Department of Internal Medicine, Hanyang University College of Medicine)
  • 송성헌 (제주한라병원 호흡기내과) ;
  • 손장원 (한양대학교 의과대학 내과학교실) ;
  • 곽현정 (한양대학교 의과대학 내과학교실) ;
  • 김사일 (한양대학교 의과대학 내과학교실) ;
  • 김상헌 (한양대학교 의과대학 내과학교실) ;
  • 김태형 (한양대학교 의과대학 내과학교실) ;
  • 윤호주 (한양대학교 의과대학 내과학교실) ;
  • 신동호 (한양대학교 의과대학 내과학교실) ;
  • 최윤영 (한양대학교 의과대학 핵의학교실) ;
  • 박성수 (한양대학교 의과대학 내과학교실)
  • Received : 2011.04.25
  • Accepted : 2011.06.29
  • Published : 2011.12.30
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Abstract

Background: High 2-[$^{18}F$] 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 (${\geq}5.9$) 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).

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