Total lesion glycolysis by 18F-FDG PET/CT is independent prognostic factor in patients with advanced non-small cell lung cancer.

BACKGROUND AND AIMS

To determine whether the primary tumor SUVmax and total lesion glycolysis (TLG) measured on F-FDG PET/CT have prognostic significance in patients with non-small-cell lung cancer (NSCLC).

METHODS

A retrospective review identified 142 patients NSCLC who underwent F-FDG PET/CT at the time of diagnosis. The affect of the SUVmax and TLG of the primary tumor on survival were examined.

RESULTS

Total 142 patients were included the study. Thirty-two patients were at early stage (stage I and II) and 110 patients were at advanced stage (stage III and IV). Both early and advanced stage patients were divided into two groups according to SUVmax 12 as low and high SUVmax groups. Overall survival (OS) of the low SUVmax group was significantly longer than higher SUVmax group for early-stage patients (35.8 ± 15.3 vs 21.8 ± 13.3, P = 0.013). But there was no differences in advanced stage patients for OS (16.1 ± 14.8 vs 17.0 ± 15.1, P = 0.862). Primary lesion TLG of the 99 patients were calculated. For advanced stage, the patients with the lower TLG had significantly longer survival time (P < 0.001). In multivariate analysis only TLG remained significant predictor of OS in advanced stage patients (HR and 95% confidence interval = 7.716 and 1.664-4.342, respectively).

CONCLUSION

High SUVmax is related to poor OS in patients with surgically resected early stage (stage I and II) NSCLC, but it is not an independent prognostic factor. TLG is a prognostic measurement and it is independent predictor factor of survival for advanced stage NSCLC.