The aim of the current study was to investigate the prognostic value of SUV max in patients with completely resected early stage (stage I & II) NSCLC.A retrospective review identified 76 patients with surgically resected early (stage I and II) NSCLC who received F-18 FDG PET/CT at diagnosis of cancer. Survival analysis was conducted using Kaplan-Meier analysis, and survival curves stratified by age, sex, mediastinal lymph node involvement, SUV max , and TNM staging were generated for estimation of overall survival and disease free survival (DFS). Independent predictive factors for survival were determined using Cox proportional hazard model.For overall survival, the median survival of the patients with tumor SUV max ≤6.7 was 48.9 months and was significantly longer than the patients with tumor SUV max >6.7 (Log rank test, Χ 2 =18.01, p<0.0001). The overall DFS was better in patients with tumor SUV max ≤5.9 than the patients with tumor SUV max >5.9. The median survival of the patients with tumor SUV max ≤5.9 was 31.7 months (Log rank test, Χ 2 =16, p=0.0001). In conclusion, high FDG uptake measured by F-18 FDG PET/CT might have a prognostic value for overall survival and DFS in surgically resected early stage (stage I & II) NSCLC even after stratified by pathologic stages. Traditionally, early stage non-small cell lung cancer (NSCLC) is managed with surgical resection. In contrast to locally advanced and metastatic NSCLC, the prognosis following resection for early stage disease is favorable. In a number of reports, 5 year survival rates for patients with stage I disease range 60~75 %, while for stage II disease five-year survival rates vary from 36~60 % [2-6]. However, the recurrence rate after curative resection still remains high and approximately half of the patients may relapse and die within 5 years, and majority of these relapses are due to distant metastasis and occur within 2 years after complete resection [7,8].Fluorine-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) has been established as a standard imaging technique in staging, treatment monitoring, prediction of survival after treatment, and follow-up of NSCLC patients [9][10][11][12][13][14][15]. Maximal standardized uptake value (SUV max ) measured by F-18 FDG PET is a semiquantitative index reflecting tumor metabolism and activities.Several previous studies suggested the prognostic role of F-18 FDG PET in patients with early stage NSCLC after complete resection [16][17][18][19][20]. Although different threshold SUV max values were proposed, high FDG uptake is associated with reduced overall survival and disease-free survival of patients with completely resected early stage NSCLC.In the current study, we investigated the prognostic value of SUV max measured by preoperative F-18 FDG PET in patients with completely resected early stage (stage I & II) NSCLC.

In a Japanese study, cyclin-dependent kinase (CDK) based risk determined by CDK 1 and 2 activities was associated with risk of distance recurrence in early breast cancer patients. The aim of our study was to validate this risk categorization in European early breast cancer patients. We retrospectively analyzed frozen breast cancer specimens of 352 Dutch patients with histologically confirmed primary invasive early breast cancer. CDK-based risk was determined in tumour tissues by calculating a risk score (RS) according to kinases activity and protein mass concentration assay without the knowledge of outcome. Determination of CDK-based risk was feasible in 184 out of 352 (52%) tumours. Median follow-up of these patients was 15 years. In patients not receiving systemic treatment, the proportions of risk categories were 44% low, 16% intermediate, and 40% high CDK-based risk. These groups remained significant after univariate and multivariate Cox-regression analysis. Factors associated with a shorter distant recurrence-free period were positive lymph nodes, mastectomy with radiotherapy, and high CDK-based risk. There was no significant correlation with overall survival (OS). CDK-based risk is a prognostic marker of distance recurrence of patients with early breast cancer. More validation would be warranted to use of CDK-based risk into clinical practice.