Clinical Investigation
Mid-long-term prognostic value of preoperative 18F-FDG PET/CT imaging on patients with resectable non-small cell lung cancer
Chen Xuetao, Zhang Yuyi, Yao Zhiming, Luo Shiyu, Chen Congxia, Li Xu
Published 2020-04-25
Cite as Chin J Nucl Med Mol Imaging, 2020,40(04): 219-223. DOI: 10.3760/cma.j.cn321828-20190801-00156
Abstract
ObjectiveTo investigate the role of preoperative 18F-fluorodeoxyglucose (FDG) PET/CT imaging in mid-long-term prognosis of patients with resectable non-small cell lung cancer (NSCLC).
MethodsSeventy resectable NSCLC patients (35 males, 35 females, median age 64 years) in Beijing Hospital between April 2010 and August 2016 were enrolled into this retrospectively study. All patients underwent 18F-FDG PET/CT imaging followed by pulmonary resection with mediastinal or hilar lymph nodes dissection within 1 month. The findings of PET/CT imaging including characteristics of primary lesions and mediastinal or hilar lymph nodes (size and maximum standardized uptake value (SUVmax) of primary lesion, SUVmax and distribution of high metabolic lymph nodes (HML)) were analyzed, and patients were followed up. Survival outcome indicators were defined as overall survival (OS) and progression-free survival (PFS). Survival analysis was conducted by Kaplan-Meier method, log-rank method and Cox proportional hazard models to assess the predictive factors.
ResultsPatients were followed up for 0.9-8.2 years. Among 70 patients, 31.4% (22/70) had disease progression and 24.3% (17/70) died. As for OS, there were significantly differences between patients with SUVmax of primary lesion≥10 and <10 (4.6 vs 7.6 years), with size of primary lesion >3 cm and ≤3 cm (4.8 vs 7.4 years), with unilateral mediastinal or hilar HML and bilateral sides or without HML (4.4 vs 7.4 years), with SUVmax of mediastinal or hilar lymph nodes ≥5.0 and <5.0 (3.8 vs 7.3 years) (χ2 values: 10.135-15.238, all P<0.01), as well as PFS (3.9 vs 6.7, 3.8 vs 6.6, 3.8 vs 6.4, 3.3 vs 6.3 years; χ2 values: 8.410-14.600, all P<0.01). Cox multivariate analysis demonstrated that the size and SUVmax of primary lesion were independent predictive factors of OS and PFS (all P<0.01). Moreover, the distribution of mediastinal or hilar HML had marginal significance in predicting OS (P=0.051).
ConclusionsSize and SUVmax of primary lesion in preoperative 18F-FDG PET/CT imaging are predictive factors for the survival of postoperative NSCLC. The distribution of the mediastinal or hilar HML may have significance for the survival prediction of postoperative NSCLC.
Key words:
Carcinoma, non-small-cell lung; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose; Prognosis
Contributor Information
Chen Xuetao
Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Zhang Yuyi
Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Yao Zhiming
Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Luo Shiyu
Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Chen Congxia
Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
Li Xu
Department of Nuclear Medicine, Beijing Hospital, National Center of Gerontology, Beijing 100730, China
