title: Are there radiographic, metabolic, and prognostic differences between cavitary and noncavitary nonsmall cell lung carcinoma? A retrospective fluorodeoxyglucose positron emission tomography/computed tomography study.
abstract: OBJECTIVE
  The prognosis of nonsmall cell lung cancer with cavitation (NSCLC-c) is not well-known. We compared the positron emission tomography/computed tomography (PET/CT) findings and survival data of patients with NSCLC-c patients with those without cavitation (NSCLC-nc).
  
  
  METHODS
  Between 7/2004 and 6/2007, cavitary lung lesions were identified in 46/248 patients undergoing fluorodeoxyglucose (FDG) PET/CT for lung nodule characterization or lung cancer staging. Within the same period, 40 of 202 patients with NSCLC-nc were randomly selected for comparison. The primary was assessed by location, size, cell type, and standardized uptake value (SUV). Disease stage was determined according to American Joint Committee on Cancer guidelines for lung cancer. Kaplan-Meier method was used for survival analysis and Cox regression to assess the effect of clinical and imaging variables on survival.
  
  
  RESULTS
  NSCLC-c was found in 87% of patients that had a cavitary lung lesion at PET/CT. Squamous cell carcinoma, primary size and primary-to-liver SUV ratio differed significantly between NSCLC-c and NSCLC-nc, whereas age, gender, primary location, primary SUV, type of treatment, and disease stage did not. Median survival and overall 5-year survival were 19 months and 24% for NSCLC-c, and 31 months and 31% for NSCLC-nc, P = 0.23. Disease stage was the only predictor of survival.
  
  
  CONCLUSIONS
  Cavitary lung lesions in patients undergoing FDG PET/CT harbor a significant risk for cancer. NSCLC-c is associated with squamous cell carcinoma, larger size, and greater FDG metabolism compared with NSCLC-nc, although these variables may not be predictive of survival. Nonetheless, PET/CT contributes to accurate staging and has an indirect impact on prognosis.
authors.affiliation: Department of Radiology, Saint Louis University, Saint Louis, MO, USA.
authors.forename: Nghi C
authors.initials: NC
authors.lastname: Nguyen
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Saint Louis University, Saint Louis, MO, USA.
authors.forename: Kumar
authors.initials: K
authors.lastname: Abhishek
authors.affiliation: School of Medicine, Saint Louis University, Saint Louis, MO, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Nyon
authors.affiliation: Department of Clinical Oncology and Nuclear Medicine, Nuclear Medicine Unit, Assiut University Hospital, Egypt.
authors.forename: Hussein Rabie S
authors.initials: HR
authors.lastname: Farghaly
authors.affiliation: Department of Radiology, Saint Louis University, Saint Louis, MO, USA.
authors.forename: Medhat M
authors.initials: MM
authors.lastname: Osman
authors.affiliation: Department of Internal Medicine, Division of Hematology and Oncology, Saint Louis University, Saint Louis, MO, USA.
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Reimers
keywords: Cavitary nonsmall cell lung cancer; fluorodeoxyglucose positron emission tomography/computed tomography; survival