title: Total lesion glycolysis by 18F-FDG PET/CT is independent prognostic factor in patients with advanced non-small cell lung cancer.
abstract: OBJECTIVE
  To determine whether the primary tumor SUVmax and total lesion glycolysis (TLG) measured on18F-FDG PET/CT have prognostic significance in patients with non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  A retrospective review identified 142 patients NSCLC who underwent18F-FDG PET/CT at the time of diagnosis. The affect of the SUVmax and TLG of the primary tumor on survival were examined.
  
  
  RESULTS
  Total 142 patients were included the study. Thirty-two patients were at early stage (stage I and II) and 110 patients were at advanced stage (stage III and IV). Both early and advanced stage patients were divided into two groups according to SUVmax 12 as low and high SUVmax groups. Overall survival (OS) of the low SUVmax group was significantly longer than higher SUVmax group for early-stage patients (35.8 ± 15.3 vs 21.8 ± 13.3, P = 0.013). But there was no differences in advanced stage patients for OS (16.1 ± 14.8 vs 17.0 ± 15.1, P = 0.862). Primary lesion TLG of the 99 patients were calculated. For advanced stage, the patients with the lower TLG had significantly longer survival time (P < 0.001). In multivariate analysis only TLG remained significant predictor of OS in advanced stage patients (HR and 95% confidence interval = 7.716 and 1.664-4.342, respectively).
  
  
  CONCLUSIONS
  High SUVmax is related to poor OS in patients with surgically resected early stage (stage I and II) NSCLC, but it is not an independent prognostic factor. TLG is a prognostic measurement and it is independent predictor factor of survival for advanced stage NSCLC.
authors.affiliation: Department of Pulmonary Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Yıldırım
authors.affiliation: Department of Pulmonary Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ahmet Selim
authors.initials: AS
authors.lastname: Yurdakul
authors.affiliation: Department of Pulmonary Medicine, Bahçeşehir University Faculty of Medicine, Istanbul, Turkey.
authors.forename: Sevket
authors.initials: S
authors.lastname: Özkaya
authors.affiliation: Department of Nuclear Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ümit Özgür
authors.initials: ÜÖ
authors.lastname: Akdemir
authors.affiliation: Department of Pulmonary Medicine, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Can
authors.initials: C
authors.lastname: Öztürk
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006019:Glycolysis / Q000502:physiology*; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011379:Prognosis; D019275:Radiopharmaceuticals / Q000378:metabolism; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: SUVmax; median tumor volume; non-small cell lung cancer; total lesion glycolysis