Preoperative consolidation-to-tumor ratio and SUVmax stratify the risk of recurrence in patients undergoing limited resection for lung adenocarcinoma ≤ 2 cm Journal Article

   

Authors:	Nitadori, J.; Bograd, A. J.; Morales, E. A.; Rizk, N. P.; Dunphy, M. P. S.; Sima, C. S.; Rusch, V. W.; Adusumilli, P. S.
Article Title:	Preoperative consolidation-to-tumor ratio and SUVmax stratify the risk of recurrence in patients undergoing limited resection for lung adenocarcinoma ≤ 2 cm
Abstract:	Purpose. Limited resection is an increasingly utilized option for treatment of clinical stage IA lung adenocarcinoma (ADC) <= 2 cm (T1aN0M0), yet there are no validated predictive factors for postoperative recurrence. We investigated the prognostic value of preoperative consolidation/tumor (C/T) ratio [on computed tomography (CT) scan] and maximum standardized uptake value (SUVmax) on F-18-fluorodeoxyglucose-positron emission tomography (PET) scan. Methods. We retrospectively reviewed 962 consecutive patients who underwent limited resection for lung cancer at Memorial Sloan-Kettering between 2000 and 2008. Patients with available CT and PET scans were included in the analysis. C/T ratio of 25 % (in accordance with the Japan Clinical Oncology Group 0201) and SUVmax of 2.2 (cohort median) were used as cutoffs. Cumulative incidence of recurrence (CIR) was assessed. Results. A total of 181 patients met the study inclusion criteria. Patients with a low C/T ratio (n = 15) had a significantly lower 5-year recurrence rate compared with patients with a high C/T ratio (n = 166) (5-year CIR, 0 vs. 33 %; p = 0.015), as did patients with low SUVmax (n = 86) compared with patients with high SUVmax (n = 95; 5-year CIR, 18 vs. 40 %; p = 0.002). Furthermore, within the high C/T ratio group, SUVmax further stratified risk of recurrence [5-year CIR, 22 % (low) vs. 40 % (high); p = 0.018]. Conclusions. With the expected increase in diagnoses of small lung ADC as a result of more widespread use of CT screening, C/T ratio and SUVmax are widely available markers that can be used to stratify the risk of recurrence among cT1aN0M0 patients after limited resection.
Keywords:	survival; tomography; carcinoma; trial; positron-emission-tomography; multicenter; positron emission; limited resection; thin-section ct; sublobar resection; ground-glass opacity; cancer; small lung adenocarcinoma; suvmax; consolidation/tumor ratio; biologic behavior
Journal Title:	Annals of Surgical Oncology
Volume:	20
Issue:	13
ISSN:	1068-9265
Publisher:	Springer
Date Published:	2013-12-01
Start Page:	4282
End Page:	4288
Language:	English
ACCESSION:	WOS:000328256600036
DOI:	10.1245/s10434-013-3212-2
PROVIDER:	wos
PUBMED:	23955584
PMCID:	PMC4373319
Notes:	Article -- Source: Wos

https://synapse.mskcc.org/synapse/works/has_related_data_chk/48938