Domachevsky L, Groshar D, Galili R, Saute M, Bernstine H
Department of Nuclear Medicine, Rabin Medical Center, Petah Tikva, Israel.
Beilinson Hospital, 39 Jabotinski St., Petah Tikva, Israel, 4941492.
Eur Radiol. 2015 Nov;25(11):3361-7. doi: 10.1007/s00330-015-3754-8. Epub 2015 May 1.
The prognosis of patients with non-small cell lung cancer (NSCLC) is important, as patients with resectable disease and poor prognostic variables might benefit from neoadjuvant therapy. The goal of this study is to evaluate SUVmax, SUVmax ratio, CT volume (CTvol), metabolic tumour volume (MTV) and total lesion glycolisis (TLG) as survival prognostic markers. In addition, we defined two variables; MTV x SUVmax (MTVmax) and CTvol x SUVmax (CTvolmax) and assessed whether they can be used as prognostic markers.
Patients with stage I-II NSCLC who underwent 18 F FDG PET/CT and surgery were evaluated. Cox proportional-hazard model was used to determine the association between variables and survival. Similar analysis was performed in cases with no lymph node (LN) involvement.
One hundred and eighty-one patients were included (at the end of the study, 140 patients were alive). SUVmax with a cut-off value of 8.2 was significant survival prognostic factor regardless of LN involvement (P = 0.012). In cases with no LN involvement, SUVmax and CTvol (≥7.1 ml) were significant survival prognostic factors with P = 0.004 and 0.03, respectively.
SUVmax may be a useful prognostic variable in stage I-II NSCLC while morphologic tumour volume might be useful in cases with no lymph node involvement.
• Identifying variables that predict the prognosis of patients with NSCLC is important. • SUVmax in primary lung tumour is a useful independent prognostic variable. • (CTvol) is an independent prognostic variable if no lymph nodes are involved.
非小细胞肺癌（NSCLC）患者的预后很重要，因为可切除疾病且预后变量较差的患者可能从新辅助治疗中获益。本研究的目的是评估SUVmax、SUVmax比值、CT体积（CTvol）、代谢肿瘤体积（MTV）和总病变糖酵解（TLG）作为生存预后标志物。此外，我们定义了两个变量：MTV×SUVmax（MTVmax）和CTvol×SUVmax（CTvolmax），并评估它们是否可作为预后标志物。
对接受18F FDG PET/CT和手术的I-II期NSCLC患者进行评估。采用Cox比例风险模型确定变量与生存之间的关联。对无淋巴结（LN）受累的病例进行了类似分析。
纳入181例患者（研究结束时，140例患者存活）。无论LN受累情况如何，SUVmax临界值为8.2是显著的生存预后因素（P = 0.012）。在无LN受累的病例中，SUVmax和CTvol（≥7.1 ml）是显著的生存预后因素，P分别为0.004和0.03。
SUVmax可能是I-II期NSCLC中一个有用的预后变量，而形态学肿瘤体积在无淋巴结受累的病例中可能有用。
• 识别预测NSCLC患者预后的变量很重要。• 原发性肺肿瘤中的SUVmax是一个有用的独立预后变量。• 如果无淋巴结受累，（CTvol）是一个独立的预后变量。
