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K. Nishiyama
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P2.06 - Poster Session/ Screening and Early Detection (ID 219)
- Event: WCLC 2015
- Type: Poster
- Track: Screening and Early Detection
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.06-028 - Accumulation of 18F-FDG Might Predict the Survival of Early-Stage Lung Cancer Patients (ID 1638)
09:30 - 09:30 | Author(s): K. Nishiyama
- Abstract
Background:
In recent years, the outcome of surgically treated early lung cancer patients have improved steadily. However postoperative recurrence following early stage lung cancer surgery can occur: 10-20% possibility of recurrence presents within 5 years after the initial operation. Numerous reports of various malignancies have revealed that 18-Fluoro-2-deoxy-D-glucose (18F-FDG) accumulation, evaluated by positron emission tomography, can be used to predict the prognosis of patients. Our purpose in this retrospective study was to determine if the maximum standardized uptake value (SUVmax) of a primary tumor predicts survival for patients of surgically treated early lung cancer.
Methods:
A total of 170 patients (99 males and 71 females) with curatively operated early lung cancer (p-stage I/II) were enrolled in this study between April 2010 and February 2015 at Japanese Red Cross Kyoto Daini Hospital. Lobectomy 160 cases, segmentectomy 20 cases, and wedge resection 4 cases. The FDG uptake of all primary lung tumor lesions diagnosed by conventional CT was evaluated by 18F-FDG PET/CT. The relation between SUVmax and patient survival was analyzed retrospectively. The postoperative survival rate was analyzed by Kaplan-Meier method, and the differences in survival rates were assessed by log-rank test. A probability value of <0.05 was considered significant. The optimal cut-off value of SUVmax for postoperative recurrences was determined using a receiver operating characteristic (ROC) curve.
Results:
The SUVmax of 170 patients ranged between 0 and 23.7. The median SUVmax was 3.5 for all cases, 3.5 for stage IA, 7.2 for stage IB, 8.2 for stage IIA, and 12.8 for stage IIB (P<0.01). Tumor recurrence occurred in 26 cases (15.3%). According to a survey by the ROC curve, the optimal cut-off value of SUVmax for postoperative recurrences was set at 3.75 with 81% sensitivity, 63% specificity. The survival between patients with SUVmax cut-off value 3.75 or more and patients with SUVmax less than 3.75 were statistically different. The 5-year survival for patients with SUVmax more than 3.75 was 76.6% and the 5-year survival for patients with SUVmax less than 3.75 was 90.6% (P=0.0196). However, the number of patients and the follow-up period were still not extensive enough to settle this important problem conclusively.
Conclusion:
The survival of patients with surgically treated early lung cancer might be predicted by evaluating their SUVmax using 18F-FDG -PET/CT. Among early lung cancer patients, there　are potentially advanced lung cancer. The present findings suggested that SUVmax of more than 3.75 in lung cancer patients is predictive of a higher likelihood of recurrence. We recommended close clinical follow-up of the early lung cancer patients with SUVmax more than 3.75 for early diagnosis of recurrence.
