Prognostic role of baseline 18F-FDG pet/CT in stage I and stage ii non-small cell lung cancer

Objective: investigate the prognostic role of baseline 18F-FDG PET/CT in stage I-II NSCLC.Material and methods: 296 patients were included. Clinicopathological features and PET/CT semiquantitative parameters [standardized uptake value (SUV) body weight max (SUVmax), SUV body weight mean (SUVmean), SUV lean body mass (SUVlbm), SUV body surface area (SUVbsa), metabolic tumor volume (MTV), total lesion glycolysis (TLG), ratio SUVmax/liver (S-L) and ratio SUVmax/blood-pool (S-BP) were extracted]. Anova and Kruskall-Wallis tests were used to assess the relationship between these parameters. Kaplan-Meier, univariate and multivariate analysis were performed to search independent prognostic factors for progression free (PFS), overall survival (OS) and disease specific survival (DSS).Results: Correlation between PET/CT semiquantitative parameters and histology, stage, size, grading and presence of nodal metastasis were reported. Mean PFS was 28.1 months, relapse/progression of disease occurred in 85 patients (28.7%). Mean OS was 33.3 months, death occurred in 43 patients (14.5%); specific death by NSCLC occurred in 26 subjects (8.8%). Kaplan-Meier analyses revealed most of semiquantitative parameters as predictive for PFS, OS and DSS. For DSS, this was confirmed when dividing between patients with surgery and surgery with other therapies. SUVmax, SUVmean, SUVlbm, SUVbsa and S-L revealed to be independent prognosticators for OS and DSS. S-BP was an independent prognosticator for DSS. SUVmax, SUVmean, SUVlbm, S-L and S-BP were confirmed as independent prognosticators for DSS in the group of patients treated with surgery and subsequent adjuvant therapy.Conclusion: Baseline 18F-FDG PET/CT semiquantitative parameters are confirmed as prognostic tools for stage I-II NSCLC, in particular for DSS.

Automated summary

The objective of this study was to investigate the prognostic role of baseline 18F-FDG PET/CT in stage I-II NSCLC. A total of 296 patients were included, and clinicopathological features and PET/CT semiquantitative parameters were extracted. The results showed a correlation between PET/CT semiquantitative parameters and histology, stage, size, grading, and presence of nodal metastasis. Kaplan-Meier analyses revealed most of the semiquantitative parameters as predictive for progression-free, overall survival, and disease-specific survival. SUVmax, SUVmean, SUVlbm, SUVbsa, and S-L were identified as independent prognosticators for overall survival and disease-specific survival.