FDG-PET-detected extracranial metastasis in patients with non-small cell lung cancer undergoing staging for surgery or radical radiotherapy--survival correlates with metastatic disease burden.
The prognostic significance of extracranial distant metastasis detected by positron emission tomography (PET) was investigated in patients with non-small cell lung cancer (NSCLC). Forty-two patients staged with 18F-fluorodeoxyglucose-PET-detected distant metastasis before planned surgery (n = 7) or radical radiotherapy (RT)/chemoradiotherapy (n = 35) for NSCLC were identified from a prospective database. The influence of metastasis number and other prognostic factors was investigated using Cox's regression analysis. Treatment after PET included surgery (n = 2), radical RT (n = 5), palliative RT (n = 25), chemotherapy (n = 8) or supportive care (n = 2). All but 4 patients had died by the last follow-up. Median survival was 9 months overall, 12 months for 27 patients with single PET-detected metastasis and 5 months for 15 patients with > 1 metastasis (p = 0.009). It was found that the Eastern Cooperative Oncology Group performance status (p = 0.027) but not pre-PET stage, weight loss or metastasis site correlated with survival. PET-detected metastatic tumor burden appeared to influence survival and should be evaluated as a prognostic factor in NSCLC.
MacManus
Michael R
MR
Department of Radiation Oncology, Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia. mmanus@petermac.unimelb.edu.au
Hicks
Rodney
R
Fisher
Richard
R
Rischin
Danny
D
Michael
Michael
M
Wirth
Andrew
A
Ball
David L
DL
D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000401:mortality* / Q000473:pathology*; D008297:Male; D009362:Neoplasm Metastasis / Q000000981:diagnostic imaging; D009367:Neoplasm Staging; D014055:Tomography, Emission-Computed
D019788:Fluorodeoxyglucose F18