title: Ratio of maximum standardized uptake value to primary tumor size is a prognostic factor in patients with advanced non-small cell lung cancer.
abstract: OBJECTIVE
  Ratio of maximum standardized uptake value to primary tumor size (SUVmax/tumor size) was previously demonstrated to be a more important indicator of prognosis than primary tumor SUVmax alone in surgically resected non-small cell lung cancer (NSCLC). The aim of this study was to investigate whether SUVmax/tumor size was associated with response to first-line therapy and prognosis in patients with advanced NSCLC.
  
  
  METHODS
  A retrospective review of patients who had a pretreatment (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) before receiving first-line therapy for advanced (III & IV) NSCLC was performed. Survival curves were stratified by median SUVmax and SUVmax/tumor size by the Kaplan-Meier method and statistical differences were assessed using the log-rank test. Multivariate proportional hazards (Cox) regression analyses were applied to test the SUVmax's and SUVmax/tumor size's independency of other prognostic factors for the prediction of survival.
  
  
  RESULTS
  In total 181 patients were enrolled into the current study. Median overall survival (OS) was 15.4 months (range, 3.1-64.0 months), progression-free survival (PFS) was 5.6 months (range, 0.8-29.1 months), and post-progression survival (PPS) was 8.2 months (range, 0-51.3 months). The statistical analysis data indicated that only clinical response to first-line therapy (P=0.000, OR =6.555) was independent prognostic factors for PFS, stage (P=0.028, OR =1.673) was associated with PPS independently, and for OS, SUVmax/tumor size (P=0.050, OR =1.656) and clinical response (P=0.002, OR =2.803) were all independent prognostic factors.
  
  
  CONCLUSIONS
  SUVmax/tumor size may be an important indicator of prognosis in patients with advanced NSCLC.
authors: 1 Department of Respiratory Medicine, Jinling Hospital, Clinical School of Southern Medical University, Nanjing 210002, China ; 2 Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors: Fangfang
authors: F
authors: Chen
authors: 1 Department of Respiratory Medicine, Jinling Hospital, Clinical School of Southern Medical University, Nanjing 210002, China ; 2 Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors: Yanwen
authors: Y
authors: Yao
authors: 1 Department of Respiratory Medicine, Jinling Hospital, Clinical School of Southern Medical University, Nanjing 210002, China ; 2 Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors: Chunyan
authors: C
authors: Ma
authors: 1 Department of Respiratory Medicine, Jinling Hospital, Clinical School of Southern Medical University, Nanjing 210002, China ; 2 Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors: Xingqun
authors: X
authors: Ma
authors: 1 Department of Respiratory Medicine, Jinling Hospital, Clinical School of Southern Medical University, Nanjing 210002, China ; 2 Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors: Zhaofeng
authors: Z
authors: Wang
authors: 1 Department of Respiratory Medicine, Jinling Hospital, Clinical School of Southern Medical University, Nanjing 210002, China ; 2 Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors: Tangfeng
authors: T
authors: Lv
authors: 1 Department of Respiratory Medicine, Jinling Hospital, Clinical School of Southern Medical University, Nanjing 210002, China ; 2 Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors: Xinwu
authors: X
authors: Xiao
authors: 1 Department of Respiratory Medicine, Jinling Hospital, Clinical School of Southern Medical University, Nanjing 210002, China ; 2 Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors: Jie
authors: J
authors: Yin
authors: 1 Department of Respiratory Medicine, Jinling Hospital, Clinical School of Southern Medical University, Nanjing 210002, China ; 2 Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China.
authors: Yong
authors: Y
authors: Song
keywords: 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT); Non-small cell lung cancer (NSCLC); maximum standardized uptake value (SUVmax); prognosis; therapeutic response