FDG-PET SUVmax combined with IASLC/ATS/ERS histologic classification improves the prognostic stratification of patients with stage I lung adenocarcinoma Journal Article


Authors: Kadota, K.; Colovos, C.; Suzuki, K.; Rizk, N. P.; Dunphy, M. P. S.; Zabor, E. C.; Sima, C. S.; Yoshizawa, A.; Travis, W. D.; Rusch, V. W.; Adusumilli, P. S.
Article Title: FDG-PET SUVmax combined with IASLC/ATS/ERS histologic classification improves the prognostic stratification of patients with stage I lung adenocarcinoma
Abstract: Background. We investigated the association between the newly proposed International Association for the Study of Lung Cancer (IASLC)/American Thoracic Society (ATS)/ European Respiratory Society (ERS) classification and 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET), and whether the combination of these radiologic and pathologic factors can further prognostically stratify patients with stage I lung adenocarcinoma. Methods. We retrospectively evaluated 222 patients with pathologic stage I lung adenocarcinoma who underwent FDG-PET scanning before undergoing surgical resection between 1999 and 2005. Patients were classified by histologic grade according to the IASLC/ATS/ERS classification (low, intermediate, or high grade) and by maximum standard uptake value (SUVmax) (low<3.0, high ≥3.0). The cumulative incidence of recurrence (CIR) was used to estimate recurrence probabilities. Results. Patients with high-grade histology had higher risk of recurrence (5-year CIR, 29 % [n = 25]) than those with intermediate-grade (13 % [n = 181]) or low-grade (11 % [n = 16]) histology (p = 0.046). High SUVmax was associated with high-grade histology (P<0.001) and with increased risk of recurrence compared to low SUVmax (5-year CIR, 21 % [n = 113] vs. 8 % [n = 109]; p = 0.013). Among patients with intermediate-grade histology, those with high SUVmax had higher risk of recurrence than those with low SUVmax (5-year CIR, 19 % [n = 87] vs. 7 % [n = 94]; p = 0.033). SUVmax was associated with recurrence even after adjusting for pathologic stage (p = 0.037). Conclusions. SUVmax on FDG-PET correlates with the IASLC/ATS/ERS classification and can be used to stratify patients with intermediate-grade histology, the predominant histologic subtype, into two prognostic subsets. © Society of Surgical Oncology 2012.
Keywords: adult; aged; major clinical study; histopathology; cancer recurrence; cancer staging; positron emission tomography; preoperative evaluation; retrospective study; lung adenocarcinoma; drug uptake; fluorodeoxyglucose f 18; cancer classification; cancer prognosis; american thoracic society classification; european respiratory society classification; international association for the study of lung cancer classification
Journal Title: Annals of Surgical Oncology
Volume: 19
Issue: 11
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2012-10-01
Start Page: 3598
End Page: 3605
Language: English
DOI: 10.1245/s10434-012-2414-3
PROVIDER: scopus
PUBMED: 22644511
PMCID: PMC4049004
DOI/URL:
Notes: --- - "Export Date: 3 December 2012" - "CODEN: ASONF" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Camelia S Sima
    204 Sima
  2. Valerie W Rusch
    655 Rusch
  3. Nabil Rizk
    134 Rizk
  4. Mark Phillip Dunphy
    49 Dunphy
  5. Emily Craig Zabor
    131 Zabor
  6. William D Travis
    548 Travis
  7. Kei Suzuki
    28 Suzuki
  8. Christos Colovos
    16 Colovos
  9. Kyuichi Kadota
    82 Kadota