FDG Uptake on Positron Emission Tomography Correlates with Survival and Time to Recurrence in Patients with Stage I Non-Small Cell Lung Cancer
Menée à partir de données portant sur 336 patients atteints d'un cancer primitif du poumon non à petites cellules de stade I (durée médiane de suivi : 5,1 ans), cette étude montre que le volume de fluorodésoxyglucose (18F) fixé par la tumeur, lors d'une tomographie numérique pré-opératoire par émission de positrons, est associé au délai avant récidive et à la survie des patients
Introduction : Patients with stage I NSCLC have a wide variation in outcomes, most likely because there are undetected metastases at presentation. We retrospectively reviewed patients with early stage lung cancer to determine if FDG uptake of the primary tumor as measured on PET at the time of diagnosis was associated with overall survival or time to recurrence.
Methods : We reviewed the Tumor Registry at our institution and identified 336 consecutive patients diagnosed with stage I NSCLC over a 5 year period who underwent an FDG-PET/ CT within 90 days prior to surgery. Kaplan-Meier curves were used to describe the survival and time to recurrence experience within subgroups defined by PET SUVmax. Cox proportional hazards model was used to assess the impact of PET SUVmax as a continuous variable on overall survival and time to recurrence. Logistic regression was used to analyze the effect of SUVmax on dichotomized outcomes.
Results : Three hundred thirty-six consecutive patients (176 women, 160 men) with stage I NSCLC were retrospectively reviewed. Mean SUVmax was 9.2 +/- 6.9 (range,0.6-30.3). The hazard or risk of dying and recurrence increased significantly as SUVmax increased (p=0.0008 and p=0.024, respectively).
Conclusions : Preoperative FDG uptake in the primary tumor in patients with stage I disease is associated with overall survival and time to recurrence. This may be useful in identifying early stage patients who may benefit from more aggressive therapy following surgical resection.
Journal of Thoracic Oncology , résumé, 2014