title: Primary tumour standardised uptake value is prognostic in nonsmall cell lung cancer: a multivariate pooled analysis of individual data.
abstract: (18)F-fluoro-2-deoxy-d-glucose positron emission tomography (PET) complements conventional imaging for diagnosing and staging lung cancer. Two literature-based meta-analyses suggest that maximum standardised uptake value (SUVmax) on PET has univariate prognostic value in nonsmall cell lung cancer (NSCLC). We analysed individual data pooled from 12 studies to assess the independent prognostic value of binary SUVmax for overall survival.After searching the published literature and identifying unpublished data, study coordinators were contacted and requested to provide data on individual patients. Cox regression models stratified for study were used.Data were collected for 1526 patients (median age 64 years, 60% male, 34% squamous cell carcinoma, 47% adenocarcinoma, 58% stage I-II). The combined univariate hazard ratio for SUVmax was 1.43 (95% CI 1.22-1.66) and nearly identical if the SUV threshold was calculated stratifying for histology. Multivariate analysis of patients with stage I-III disease identified age, stage, tumour size and receipt of surgery as independent prognostic factors; adding SUV (HR 1.58, 95% CI 1.27-1.96) improved the model significantly. The only detected interaction was between SUV and stage IV disease.SUV seems to have independent prognostic value in stage I-III NSCLC, for squamous cell carcinoma and for adenocarcinoma.
authors.affiliation: Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium Both authors contributed equally marianne.paesmans@bordet.be.
authors.forename: Marianne
authors.initials: M
authors.lastname: Paesmans
authors.affiliation: Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium Both authors contributed equally.
authors.forename: Camilo
authors.initials: C
authors.lastname: Garcia
authors.affiliation: Diagnostic Radiology and Molecular Imaging, Oakland University William Beaumont School of Medicine, William Beaumont Hospital, Royal Oak, MI, USA.
authors.forename: Ching-Yee Oliver
authors.initials: CY
authors.lastname: Wong
authors.affiliation: Radiology, Duke University Medical Center, Durham, NC, USA.
authors.forename: Edward F
authors.initials: EF
authors.lastname: Patz
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Komaki
authors.affiliation: Nuclear Medicine, University of Tubingen, Tubingen, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Eschmann
authors.affiliation: Division of Medical Oncology, Washington University School of Medicine, St. Louis, MI, USA.
authors.forename: Ramaswamy
authors.initials: R
authors.lastname: Govindan
authors.affiliation: Pneumology, Respiratory Oncology Unit, University Hospitals KU Leuven, Leuven, Belgium.
authors.forename: Johan
authors.initials: J
authors.lastname: Vansteenkiste
authors.affiliation: Intensive Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Anne-Pascale
authors.initials: AP
authors.lastname: Meert
authors.affiliation: Pneumology, Ziekenhuis Gelderse Vallei, Ede, The Netherlands.
authors.forename: Wouter K
authors.initials: WK
authors.lastname: de Jong
authors.affiliation: Thoracic Surgery, Weill Cornell Medical College, New York, NY, USA.
authors.forename: Nasser Khaled
authors.initials: NK
authors.lastname: Altorki
authors.affiliation: Radiology, Asanogawa General Hospital, Ishikawa, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Higashi
authors.affiliation: Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands.
authors.forename: Angela
authors.initials: A
authors.lastname: Van Baardwijk
authors.affiliation: Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: Gerben R
authors.initials: GR
authors.lastname: Borst
authors.affiliation: Data Centre, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Lieveke
authors.initials: L
authors.lastname: Ameye
authors.affiliation: Pulmonary and Thoracic Oncology, CHRU de Lille, Lille, France.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Lafitte
authors.affiliation: Intensive Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Berghmans
authors.affiliation: Nuclear Medicine, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Flamen
authors.affiliation: Thoracic Surgery, Hospital Universitari Mutua Terrassa and CIBERES Lung Cancer Group, Terrassa, Spain.
authors.forename: Ramon
authors.initials: R
authors.lastname: Rami-Porta
authors.affiliation: Intensive Care and Thoracic Oncology, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Sculier
mesh_terms: D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals; D047368:Tumor Burden
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18