Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Respiratory System, POSITRON-EMISSION-TOMOGRAPHY, TOTAL LESION GLYCOLYSIS, VALUE PREDICTS SURVIVAL, F-18-FDG UPTAKE, FDG UPTAKE, PET, STAGE, SCAN, RECURRENCE, SIZE, Adenocarcinoma, Adult, Aged, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung, Carcinoma, Squamous Cell, Female, Fluorodeoxyglucose F18, Humans, Lung Neoplasms, Male, Middle Aged, Multivariate Analysis, Neoplasm Staging, Positron-Emission Tomography, Prognosis, Proportional Hazards Models, Radiopharmaceuticals, Tumor Burden, 11 Medical and Health Sciences, 3201 Cardiovascular medicine and haematology

Abstract:

(18)F-fluoro-2-deoxy-d-glucose positron emission tomography (PET) complements conventional imaging for diagnosing and staging lung cancer. Two literature-based meta-analyses suggest that maximum standardised uptake value (SUVmax) on PET has univariate prognostic value in nonsmall cell lung cancer (NSCLC). We analysed individual data pooled from 12 studies to assess the independent prognostic value of binary SUVmax for overall survival.After searching the published literature and identifying unpublished data, study coordinators were contacted and requested to provide data on individual patients. Cox regression models stratified for study were used.Data were collected for 1526 patients (median age 64 years, 60% male, 34% squamous cell carcinoma, 47% adenocarcinoma, 58% stage I-II). The combined univariate hazard ratio for SUVmax was 1.43 (95% CI 1.22-1.66) and nearly identical if the SUV threshold was calculated stratifying for histology. Multivariate analysis of patients with stage I-III disease identified age, stage, tumour size and receipt of surgery as independent prognostic factors; adding SUV (HR 1.58, 95% CI 1.27-1.96) improved the model significantly. The only detected interaction was between SUV and stage IV disease.SUV seems to have independent prognostic value in stage I-III NSCLC, for squamous cell carcinoma and for adenocarcinoma.