Preoperative F-18 fluorodeoxyglucose-positron emission tomography maximal standardized uptake value predicts survival after lung cancer resection Journal Article


Authors: Downey, R. J.; Akhurst, T.; Gonen, M.; Vincent, A.; Bains, M. S.; Larson, S.; Rusch, V.
Article Title: Preoperative F-18 fluorodeoxyglucose-positron emission tomography maximal standardized uptake value predicts survival after lung cancer resection
Abstract: Purpose: A retrospective review of surgically treated lung cancer patients imaged preoperatively by F-18 fluorodeoxyglucose-positron emission tomography ([18F]FDG-PET) to determine if the primary tumor standardized uptake value (SUV) predicts survival. Patients and Methods: Non-small-cell lung cancer or carcinoid pT1-4, N0-2, M0 patients treated by R0 surgical resection alone were imaged with computed tomography scan and PET within 90 days before surgery. Prognostic variables were assessed by log-rank test; survival was assessed by the method of Kaplan and Meier. Results: One hundred consecutive patients (48 men, 52 women) were retrospectively reviewed. Median follow-up for surviving patients was 28 months (range, 16 to 81 months). Median maximal SUV (SUV MAX) was 9. The 2-year survival for patients with SUVMAX more than 9 was 68% and for those with SUVMAX less than 9, it was 96% (P < .01, log-rank test). In a multivariate analysis including pathologic tumor size, involved nodes, histology, and SUVMAX, only tumor size (T) more than 3 cm and SUVMAX more than 9 and their interaction were significant predictors of survival (P = .01, 0.02, and < 0.01, respectively). The 3-year survivals for patients with both T less than 3 cm and SUV MAX less than 9 was 97%; for those with T less than 3 cm and SUV MAX more than 9, it was 94%; for those with T more than 3 cm and SUVMAX less than 9, it was 93%; and for those with T more than 3 cm and SUVMAX more than 9, it was 47% (P < .01). Conclusion: In surgically managed lung cancer patients, SUV is a predictor of overall survival after resection. The addition of SUVMAX to pathologic tumor size identifies a subgroup of patients at highest risk for death as a result of recurrent disease after resection. © 2004 by American Society of Clinical Oncology.
Keywords: survival; adult; cancer survival; aged; middle aged; survival analysis; cancer surgery; retrospective studies; major clinical study; review; preoperative care; positron emission tomography; follow up; sensitivity and specificity; radiopharmaceuticals; tumor volume; lung non small cell cancer; carcinoma, non-small-cell lung; lung neoplasms; pathology; retrospective study; prediction; lung tumor; diagnostic agent; fluorodeoxyglucose f 18; computer assisted emission tomography; fluorodeoxyglucose f18; prediction and forecasting; predictive value of tests; radiopharmaceutical agent; scintiscanning; carcinoid; multivariate analysis; carcinoid tumor; tomography, emission-computed; humans; prognosis; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 22
Issue: 16
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2004-08-15
Start Page: 3255
End Page: 3260
Language: English
DOI: 10.1200/jco.2004.11.109
PROVIDER: scopus
PUBMED: 15310769
DOI/URL:
Notes: J. Clin. Oncol. -- Cited By (since 1996):223 -- Export Date: 16 June 2014 -- CODEN: JCOND -- Source: Scopus
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MSK Authors
  1. Valerie W Rusch
    864 Rusch
  2. Mithat Gonen
    1028 Gonen
  3. Timothy J Akhurst
    139 Akhurst
  4. Alain M Vincent
    20 Vincent
  5. Robert J Downey
    254 Downey
  6. Steven M Larson
    958 Larson
  7. Manjit S Bains
    338 Bains