title: Prognostic importance of the standardized uptake value on (18)F-fluoro-2-deoxy-glucose-positron emission tomography scan in non-small-cell lung cancer: An analysis of 125 cases. Leuven Lung Cancer Group.
abstract: OBJECTIVE
  The amount of radio-labeled (18)F-fluoro-2-deoxy-glucose (FDG) uptake, a measurement of the increased glucose metabolism of non-small-cell lung cancer (NSCLC) cells, has recently been correlated with proliferation capacity. The Standardized Uptake Value (SUV), a semi-quantitative measurement of FDG uptake on positron emission tomography (PET) scan, could thus be of prognostic significance.
  
  
  METHODS
  We analyzed the follow-up of 125 potentially operable NSCLC patients, previously included in three of our prospective PET protocols. Performance status, maximal tumor diameter, tumor-cell type, SUV, and final staging were analyzed for their possible association with survival.
  
  
  RESULTS
  Sixty-five patients had stage I or II NSCLC, 37 had stage IIIA, and 23 had stage IIIB. Treatment was complete resection in 91 cases. In a univariate analysis, performance status (P =.002), stage (P =.001), tumor diameter (P =.06), tumor-cell type (P =.03), and SUV greater than 7 (P =.001) were correlated with survival. For SUV, group dichotomy with a cut-off SUV of 7 had the best discriminative value for prognosis, both in the total and surgical cohort. A multivariate Cox analysis identified performance status (P =.02), stage (P =.01), and SUV (P =.007) as important for the prognosis. In the surgical group, patients with a resected tumor less than 3 cm had an expected 2-year survival of 86%, if the SUV was below 7, and 60%, if above 7. Nearly all resected tumors larger than 3 cm had SUV's greater than 7 and an expected 2-year survival of 43%.
  
  
  CONCLUSIONS
  We conclude that the FDG uptake in primary NSCLC on PET has an important prognostic value and could be complementary to other well-known factors in the decision on adjuvant treatment protocols.
authors.affiliation: Department of Pulmonology, Respiratory Oncology Unit, University Hospital Gasthuisberg, Catholic University, Leuven, Belgium. johan.vansteenkiste@uz.kuleuven.ac.be
authors.forename: J F
authors.initials: JF
authors.lastname: Vansteenkiste
authors.forename: S G
authors.initials: SG
authors.lastname: Stroobants
authors.forename: P J
authors.initials: PJ
authors.lastname: Dupont
authors.forename: P R
authors.initials: PR
authors.lastname: De Leyn
authors.forename: E K
authors.initials: EK
authors.lastname: Verbeken
authors.forename: G J
authors.initials: GJ
authors.lastname: Deneffe
authors.forename: L A
authors.initials: LA
authors.lastname: Mortelmans
authors.forename: M G
authors.initials: MG
authors.lastname: Demedts
mesh_terms: D000328:Adult; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D016019:Survival Analysis; D014055:Tomography, Emission-Computed
chemical_list: D019788:Fluorodeoxyglucose F18; D005947:Glucose