title: Primary tumor standardized uptake value (SUVmax) measured on fluorodeoxyglucose positron emission tomography (FDG-PET) is of prognostic value for survival in non-small cell lung cancer (NSCLC): a systematic review and meta-analysis (MA) by the European Lung Cancer Working Party for the IASLC Lung Cancer Staging Project.
abstract: OBJECTIVE
  The 2-[18F]-fluoro-2-deoxy-d-glucose positron emission tomography is an imaging tool for assessing clinical tumor, node, metastasis in non-small cell lung cancer (NSCLC). Primary tumor standardized uptake value (SUV) has been studied as a potential prognostic factor for survival. However, the sample sizes are limited leading to conduct a meta-analysis to improve the precision in estimating its effect.
  
  
  METHODS
  We performed a systematic literature search. For each publication, we extracted an estimate of the hazard ratio (HR) for comparing patients with a low and a high SUV and we aggregated the individual HRs into a combined HR, using a random-effects model.
  
  
  RESULTS
  We found 13 eligible studies dedicated to NSCLC. Most of them included patients with stages I to III/IV and used a SUV assessment corrected for body weight. Number of patients ranged from 38 to 315 (total: 1474); 11 studies identified a high SUV as a poor prognostic factor for survival although two studies found no significant correlation between SUV and survival. SUV measurement and SUV threshold for defining high SUV were study dependent, eight studies looked for a so-called best cutoff (maximizing the logrank test statistic) without adjusting the p value for multiplicity. Overall, the combined HR for the 13 reports was 2.27 (95% confidence interval [CI]: 1.70-3.02); excluding the studies proposing a "best" cutoff, it was 2.08 (95% CI: 1.431-3.04).
  
  
  CONCLUSIONS
  Our meta-analysis suggests that the primary tumor SUV measurement has a prognostic value in NSCLC; these results should be confirmed in a meta-analysis on individual patients' data.
authors.affiliation: Department of Intensive Care Unit and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles (ULB), Bruxelles, Belgium. thierry.berghmans@bordet.be
authors.forename: Thierry
authors.initials: T
authors.lastname: Berghmans
authors.forename: Michèle
authors.initials: M
authors.lastname: Dusart
authors.forename: Marianne
authors.initials: M
authors.lastname: Paesmans
authors.forename: Claude
authors.initials: C
authors.lastname: Hossein-Foucher
authors.forename: Irene
authors.initials: I
authors.lastname: Buvat
authors.forename: Catherine
authors.initials: C
authors.lastname: Castaigne
authors.forename: Arnaud
authors.initials: A
authors.lastname: Scherpereel
authors.forename: Céline
authors.initials: C
authors.lastname: Mascaux
authors.forename: Michel
authors.initials: M
authors.lastname: Moreau
authors.forename: Martine
authors.initials: M
authors.lastname: Roelandts
authors.forename: Stéphane
authors.initials: S
authors.lastname: Alard
authors.forename: Anne-Pascale
authors.initials: AP
authors.lastname: Meert
authors.forename: Edward F
authors.initials: EF
authors.lastname: Patz
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Lafitte
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Sculier
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D019788:Fluorodeoxyglucose F18