Prognostic Value of FDG Uptake in Stage I Non–Small-Cell Lung Cancer: Fact or Bias?

7224 Background: Lung cancer is the leading cause of cancer-related mortality in both men and women in the United States. Over 80% of patients are diagnosed with non-small cell lung cancer (NSCLC) and approximately 30% of patients with NSCLC present with resectable disease. Nearly 40–50% of patients with resected stage I NSCLC develop recurrent disease. Currently there are no clinical, radiological, or molecular markers to predict outcomes following surgery in early stage NSCLC. Positron emission tomography (PET) with 2-[18F] fluoro-2-deoxy-D-glucose (FDG-PET) is used commonly in the staging work up of NSCLC. The standardized uptake value (SUV) is a semiquantitive measure of FDG uptake that correlates with tumor doubling time. We studied the relationship between the maximum preoperative tumor SUV (SUVmax) for FDG and disease-free survival (DFS) in patients with resected stage I NSCLC. Methods: We identified 153 consecutive patients diagnosed with stage I NSCLC between 1999 and 2003 who had undergone FDG-PET before curative surgical resection. Data were collected regarding stage distribution, histology, recurrence and survival. No patient in this cohort received adjuvant chemotherapy or radiotherapy. SUVmax above and below the median was correlated with DFS. Results: Of 153 patients with stage I NSCLC, 90 (59%) had T1 and 63 (41%) had T2 tumors. The mean and median follow-up time for the cohort was 2.9 and 3.1 years respectively. The mean and median SUVs were 7.0 and 6.0 respectively. The 5-year DFS categorized by SUVmax < 6 vs. SUVmax ≥ 6 was 62% vs. 46 (p = 0.0036) for the entire cohort; 64% vs. 54% (p = 0.20) for the T1 subset; and 60% vs. 40% (p = 0.07) for the T2 subset. Conclusions: High SUVmax (≥ 6) on preoperative FDG-PET is a predictor of poor outcome in resectable stage I NSCLC. [Table: see text]

Download Full-text

Prognostic value of FDG uptake in early stage non-small cell lung cancer☆

European Journal of Cardio-Thoracic Surgery ◽

10.1016/j.ejcts.2008.02.005 ◽

2008 ◽

Vol 33 (5) ◽

pp. 819-823 ◽

Cited By ~ 63

Author(s):

François-Xavier Hanin ◽

Max Lonneux ◽

Julien Cornet ◽

Philippe Noirhomme ◽

Corinne Coulon ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Prognostic Value ◽

Early Stage ◽

Small Cell ◽

Small Cell Lung ◽

Fdg Uptake

Download Full-text

Prognostic Value of Semiautomatic CT Volumetry in Patients With Stage I Non–Small Cell Lung Cancer Treated With Stereotactic Body Radiation Therapy

Journal of Computer Assisted Tomography ◽

10.1097/rct.0000000000000368 ◽

2016 ◽

Vol 40 (3) ◽

pp. 343-350 ◽

Cited By ~ 2

Author(s):

Yoko Satoh ◽

Utaroh Motosugi ◽

Atsushi Nambu ◽

Akitoshi Saito ◽

Hiroshi Onishi

Keyword(s):

Lung Cancer ◽

Radiation Therapy ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Prognostic Value ◽

Stereotactic Body Radiation Therapy ◽

Small Cell ◽

Stage I ◽

Small Cell Lung ◽

Ct Volumetry

Download Full-text

Neutrophil to lymphocyte ratio and lipi score prognostic value in patients with non-small cell lung cancer in a Mexican population.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e21593 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e21593-e21593

Author(s):

Eduardo Reyes ◽

José Fabián Martínez-Herrera ◽

Raul Alejandro Andrade Moreno ◽

Cesar Lara - Torres ◽

Geovani Amador García ◽

...

Keyword(s):

Lung Cancer ◽

Small Cell Lung Cancer ◽

Cell Lung Cancer ◽

Prognostic Value ◽

Clinical Stage ◽

Stage Iv ◽

Small Cell ◽

Stage I ◽

Small Cell Lung ◽

Lymphocyte Ratio

e21593 Background: Non-Small cell lung cancer (NSCLC) is the most common type of lung cancer and accounts for most of all cancer-related morbidity and deaths in the World. Recent Evidence shows that inflammatory response is associated with a poor prognostic in several cancers. Evaluating these markers is of great importance to classify patients of solid tumors including NSCLC. Inflammatory markers like, Glasgow Prognostic Score (GPS), Lung Immune prognostic index (LIPI) and C-Reactive Protein (CRP) have been associated with poor prognosis in patients treated with immune checkpoint inhibitors. Neutrophil to Lymphocyte Ratio (NLR) is a biomarker for the general immune response to various stress stimuli in peripheral blood. It can be easily determined, inexpensive and can correlate with poor outcomes. Methods: A review of medical records was performed including patients from January 2013 to December 2018. The clinical characteristics were described, analyzed and the NLR and the LIPI were calculated. Categorical variables were analyzed with Chi-square test and the correlation was analyzed with the Pearson correlation coefficient. Variables were included in the construction of survival models through Cox multivariate regression using statistical software: STATA SE ver11.0 (StataCorp LLC Texas,USA). Results: A total of 175 patients with complete medical record and pathology samples were included. Around half of patients were female. The mean age was 69 years ± 11 years. The most frequent histology was Adenocarcinoma in 87%, Epidermoid 10% and others 3%. The most frequent mutations were KRAS 25%, EGFR 22% and ALK 1%. PDL-1 > 1% was determined in 20% of patients. Clinical stage IV was found in 58% of the cases followed by Clinical Stage I, II and III with 25%, 9%, 8% respectively. The NLR > 4 is associated with a worse prognosis in Stage I and II HR = 5.4 (95% CI 1.73 - 17.17, p = 0.004). LIPI > 2 had predictive capacity for progression in Stage IV HR = 8.2 (IC 95 % 2.39-23.4, p = < 0.001). Conclusions: NLR > 4 showed prognostic value for recurrence in early clinical stages. LIPI score > 2 resulted in higher risk for progression in metastatic stages. Determination of these indexes has the potential as a readily available prognostic indicator for patients.

Download Full-text