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[¹⁸F]Fluorodeoxyglucose Uptake by Positron Emission Tomography Predicts Outcome of Non–Small-Cell Lung Cancer

From the Departments of Radiation Oncology, Nuclear Medicine, Thoracic and Cardiovascular Surgery, Thoracic/Head and Neck Medical Oncology, and Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX; and Division of Radiology, Kobe University Graduate School of Medicine, Hyogo, Japan

Address reprint requests to Ritsuko Komaki, MD, Department of Radiation Oncology, Unit 97, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030; e-mail: rkomaki{at}mdanderson.org

PURPOSE: To determine whether the standardized uptake value (SUV) of [¹⁸F]fluorodeoxyglucose uptake by positron emission tomography could be a prognostic factor for non–small-cell lung cancer (NSCLC).

PATIENTS AND METHODS: One hundred sixty-two patients with stage I to IIIb NSCLC were analyzed. Overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS), and local-regional control (LRC) were calculated by the Kaplan-Meier method and evaluated with the log-rank test. The prognostic significance was assessed by univariate and multivariate analyses.

RESULTS: There were 93 patients treated with surgery and 69 patients treated with radiotherapy. A cutoff of 5 for the SUV for the primary tumor showed the best discriminative value. The SUV for the primary tumor was a significant predictor of OS (P = .02) in both groups. Low SUVs ( 5.0) showed significantly better DFS rates than those with high SUVs (> 5.0; surgery group, P = .02; radiotherapy group, P = .0005). Low SUVs ( 5.0) indicated a significantly better DFS than those with high SUVs (> 5.0; stage I or II, P = .02; stage IIIa or IIIb, P = .004). However, using the same cutoff point of 5, the SUV for regional lymph nodes was not a significant indicator for DFS (P = .19), LRC (P = .97), or DMFS (P = .17). The multivariate analysis showed that the SUV for the primary tumor was a significant prognostic factor for OS (P = .03) and DFS (P = .001).

CONCLUSION: The SUV of the primary tumor was the strongest prognostic factor among the patients treated by curative surgery or radiotherapy.

R.S. is supported by a research fellowship grant from the Uehara Memorial Foundation, Kobe City, Japan.

Authors' disclosures of potential conflicts of interest are found at the end of this article.

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