Limited prognostic value of dual time point F-18 FDG PET/CT in patients with early stage (stage I & II) non-small cell lung cancer (NSCLC).

Abstract

The aim of the current study was to investigate the prognostic value of dual time point F-18 FDG PET/CT in patients with early stage (stage I & II) NSCLC. A retrospective review identified 66 patients with surgically resected early (stage I & II) NSCLC who received dual time point 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, TNM staging, SUV(maxE), SUV(maxD), and %ΔSUV(max) were generated for estimation of overall survival and disease-free survival (DFS). Independent predictive factors for survival were determined using Cox proportional hazard model. The overall survival and DFS were better in patients with tumor SUV(maxE)≤5.75 than the patients with tumor SUV(maxE)≥5.75. Seventeen patients (18.2%) with a tumor SUV(maxD)≥6.8 and 4 of 33 patients with tumor SUV(maxD)≤6.8 recurred during follow-up period. The median disease-free survival of the patients with tumor SUV(maxD)≥6.8 was 31.7 months and was significantly worse than the patients with tumor SUV(maxD)≤6.8 (Log rank test, Χ(2)=10.45, p=0.0012). The %ΔSUV(max) did not have prognostic values for overall survival and disease-free survival. The SUV(maxE) and SUV(maxD) were the potent predictors for overall survival. Also, the potent predictor of DFS was the SUV(maxE). In conclusion, %ΔSUV(max) measured by dual time point F-18 FDG PET/CT might not have a prognostic value for overall survival and DFS in surgically resected early stage (stage I & II) NSCLC.