High Tumor Metabolic Activity as Measured by Fluorodeoxyglucose Positron Emission Tomography Is Associated with Poor Prognosis in Limited and Extensive Stage Small-Cell Lung Cancer

Abstract

Purpose: We investigated the prognostic effect of incorporating metabolic assessment by 18 F-fluoro-2-deoxyglucose uptake on positron emission tomography/computed tomography ( 18 F-FDG-PET/CT) into a conventional staging system in small-cell lung cancer (SCLC). Experimental Design: Seventy-six consecutive patients with pathologically proven SCLC were enrolled. All patients underwent standard treatment after pretreatment Results: Patients with high meanSUV max were significantly related with the established poor prognostic factors, such as higher lactate dehydrogenase (P = 0.04) and extensive disease (ED; P = 0.01). Furthermore, in multivariate analysis, patients with high meanSUV max were associated with poor survival outcomes compared with patients with low meanSUV max [adjusted hazard ratio, 3.74; 95% confidence interval (95% CI), 1.67-8.37; P = 0.001, for death and adjusted hazard ratio, 2.25; 95% CI, 1.21-4.17; P = 0.01for recurrence/progression]. In subgroup analysis, limited disease (LD) with high meanSUV max showed significantly shorter overall survival than LD with low meanSUV max [high versus low meanSUV max , 20.1 months (95% CI, 7.9-23.2) versus 35.3 months (95% CI, 27.6-42.9); P = 0.02]. ED with high meanSUV max had significantly shorter overall survival than ED with low meanSUV max [high versus low meanSUV max , 9.5 months (95% CI, 4.9-13.9) versus 17.7 months (95% CI, 12.0-20.1); P = 0.007]. These findings were replicated in progression-free survival analysis. Conclusions: In SCLC, tumor metabolic activity as assessed by FDG-PET is a significant prognostic factor and identifies subgroups of patients at higher risk of death in both LD and ED SCLC.

Prognostic value of FDG-PET scans at diagnosis in small cell lung cancer

“…Our study showed that the SUV mean is not correlated with overall survival and this finding is in accord with previously published data by Joo Lee et al, which showed that a high SUV mean value has prognostic value but that low SUV mean does not [30] .…”

Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Diagnosis and Staging of Lung Cancer

“…Evrelemede FDG PET/BT görüntülemenin kullanılması KHAK evresinde ve tedavi planında %11-%37 oranında değişikliğe neden olmaktadır (37,38,39). Akciğer kanserinde genel olarak gözlenen SUV maks ve metabolik tümör volümü (MTV) değerleri ile sağkalım arasındaki ilişkiler KHAK için de geçerlidir (39,40,41).…”

Therapy Response Evaluation With Fdg-Pet/Ct In Thoracic Malignancies

“…KHAK hastalarında KRT'ye olan yanıt KHDAK hastalarına göre çok daha çabuk geliştiğinden bu hasta grubunda morfolojik değerlendirme daha erken dönemde yapılabilmektedir. PET/BT ile yapılan metabolik değerlendirmenin sağkalım ile ilgisinin araştırıldığı sınırlı sayıdaki çalışmada metabolik yanıtlı grupta daha uzun sağkalım olduğu saptanmıştır (22,23). PERCIST ve EORTC kriterlerine göre FDG-PET/BT ile yapılan metabolik değerlendirmenin sonuçları arasında anlamlı fark saptanmadığı da bildirilmektedir (24).…”