Primary tumour standardised uptake value is prognostic in nonsmall cell lung cancer: a multivariate pooled analysis of individual data

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prognostic value of binary SUVmax for overall survival.After searching the published literature and identifying unpublished data, study coordinators were contacted and requested to provide data on individual patients.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. @ERSpublications SUV has independent prognostic value in stage I-III NSCLC, both for squamous cell carcinoma and for adenocarcinoma

Primary Sarcomatoid Carcinoma of the Lung: Radiometabolic (18F-FDG PET/CT) Findings and Correlation with Clinico-Pathological and Survival Results

“…T-stage, N-stage, complexity of surgical procedure and overall survival) [13]. A multivariate pooled analysis of survival in 1526 NSCLC patients confirmed SUVmax as independent prognostic factor ''in adenocarcinoma and squamous cell carcinoma'' [14], and similar conclusions were reported by another meta-analysis [15].…”

Prognostic impact of maximum standardized uptake value (SUVmax) of the primary lesion on survival in advanced non-small-cell lung cancer: A retrospective study

“…The evaluation of SUV is intuitive and convenient, but whether SUVmax provides additional prognostic value in addition to the TNM stage remains to be explored [12,13,21]. Previous studies showed that higher SUVmax was associated with worse overall survival, but these studies were mostly based on early stage lung cancer [4,6,18,22],and results have been con icting.…”

“…Several studies have shown a high sensitivity,speci city,and accuracy of PET/CT for diagnosis,staging [2][3][4]12],post-therapy assessment, and outcome prediction [2,4,7,8,10,11,[13][14][15][16][17][18][19] as well as its utility as an accurate and non-invasive modality in clinical practice. However, the methods in these studies differ and their conclusions are not completely consistent [12,20,21]. Furthermore, the utility of SUV for predicting survival in advanced NSCLC requires further study.…”

Asphericity of Tumor FDG Uptake in Non-Small Cell Lung Cancer: Reproducibility and Implications for Harmonization in Multicenter Studies

“…The largest study (311 patients, UICC stage I-III) further showed that ASP, with an optimal cut-off of > 19.5%, could identify patients with UICC stage II treated by surgery and adjuvant chemotherapy with high ASP and reduced PFS (median, 11 months vs. not reached) and OS (22 months vs. not reached) (15). ASP was superior for survival prediction compared to primary tumor's maximum standardized uptake value (SUVmax) and MTV, two other previously proposed and common PET parameters (8,9,16,17).…”