title: Prognostic value of total lesion glycolysis by 18F-FDG PET/CT in surgically resected stage IA non-small cell lung cancer.
abstract: Despite the favorable prognosis of stage IA non-small cell lung cancer (NSCLC), the disease recurs after complete surgical resection in 20%-30% of patients. This study determined the prognostic value of various metabolic parameters of (18)F-FDG PET/CT in surgically resected stage IA NSCLC.
  
  
  METHODS
  We retrospectively reviewed 248 patients with stage IA NSCLC who underwent lobectomy and complete lymph node dissection after PET/CT. A region of interest was drawn on the primary lesion, and metabolic indices such as metabolic tumor volume, maximum standardized uptake value (SUV(max)), and total lesion glycolysis (TLG) were measured using an SUV cutoff of 2.5.
  
  
  RESULTS
  The patients included 134 men and 114 women, and the mean age was 63.03 ± 10.01 y; 129 were stage T1a (≤ 2 cm) and 119 were T1b (>2 cm). The median follow-up period was 36.6 mo. Recurrence took place in 15 patients. The mean (± SD) SUV(max), metabolic tumor volume, and TLG were 4.55 ± 3.75, 5.92 ± 5.57, and 14.42 ± 17.35, respectively. The cutoffs of SUV(max) and TLG were 3.7 and 13.76, respectively. The 5-y overall survival (OS) was 95.1% in low-SUV(max) patients and 82.2% in high-SUV(max) patients (P = 0.02). The 5-y OS was 93.7% in low-TLG patients and 78.3% in high-TLG patients (P = 0.01). On multivariate analysis, TLG was a risk factor for OS (hazard ratio, 3.159; P = 0.040), but SUV(max) showed marginal significance (P = 0.064). The concordance index of the TLG model was 0.676 (95% CI, 0.541-0.812).
  
  
  CONCLUSIONS
  TLG was a significant prognostic factor for OS in patients with stage IA NSCLC.
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Seong Yong
authors.initials: SY
authors.lastname: Park
authors.affiliation: Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; and.
authors.forename: Arthur
authors.initials: A
authors.lastname: Cho
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea kychu@yuhs.ac.
authors.forename: Woo Sik
authors.initials: WS
authors.lastname: Yu
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Chang Young
authors.initials: CY
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jin Gu
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Dae Joon
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea kychu@yuhs.ac.
authors.forename: Kyung Young
authors.initials: KY
authors.lastname: Chung
mesh_terms: D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006019:Glycolysis; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: PET-CT; lung cancer surgery; statistics; survival analysis; volume-dependent parameter