title: Prognostic value of pre-operative glucose-corrected maximum standardized uptake value in patients with non-small cell lung cancer after complete surgical resection and 5-year follow-up.
abstract: BACKGROUND
  In this study we evaluated the value of pre-operative glucose corrected maximum standard uptake value (GC-SUVmax) as prognostic factor in patients with early stage non-small cell lung cancer (NSCLC) after complete surgical resection.
  
  
  METHODS
  This study was designed as a retrospectively evaluated single center study with prospective data registry. Inclusion criteria were: histologically proven stage I NSCLC, 18F-FDG-PET/CT scan prior to surgery, complete resection (R0) and follow up in our outpatient department. Exclusion criteria were: history of malignancy other than NSCLC, diabetes and (neo) adjuvant therapy. Follow up period was 5 years.
  
  
  RESULTS
  Between 2006 and 2008 a total of 33 patients (16 males, 17 females) met the inclusion criteria. SUVmax and GC-SUVmax were strongly correlated (Spearman's ρ = 0.97). Five-year overall survival (OS) rate was 70 % (95 % CI = 56-87 %). Patients who died within 5 years of follow up had significantly higher pre-operative GC-SUVmax (median = 10.6, IQR = 8.3-14.4) than patients who were alive at 5-year follow up (median = 6.4, IQR = 3.0-9.8), p = 0.04. SUVmax showed similar differences: 10.4 (8-12.9) vs. 6.6 (3.0-8.8), p = 0.047. The area under the receiver-operating characteristic (ROC) curve at 5 years was 0.70 (95 % CI = 0.50-0.90) for GC-SUVmax and 0.71 (95 % CI = 0.51-0.91) for SUVmax (p = 0.75).
  
  
  CONCLUSIONS
  Pre-operative FDG tumor uptake in patients with NSCLC is predictive for survival after complete surgical resection. GC-SUVmax, as an additional value to SUVmax, may better approach competitive inhibition of FDG and glucose in tumors, however, in this study this potential advantage, if any, was very small.
authors.affiliation: Department of Surgery, Spaarne Gasthuis, Haarlem, The Netherlands.
authors.forename: Renske
authors.initials: R
authors.lastname: Konings
authors.affiliation: Department of Surgical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands. m.v.gool@nki.nl.
authors.forename: Matthijs H
authors.initials: MH
authors.lastname: van Gool
authors.affiliation: Department of Pulmonology, Spaarne Gasthuis, Haarlem, The Netherlands.
authors.forename: Martin P L
authors.initials: MP
authors.lastname: Bard
authors.affiliation: Department of Nuclear Medicine, Spaarne Gasthuis, Haarlem, The Netherlands.
authors.forename: Anthonie
authors.initials: A
authors.lastname: Zwijnenburg
authors.affiliation: Department of Nuclear Medicine, Spaarne Gasthuis, Haarlem, The Netherlands.
authors.forename: Bart M
authors.initials: BM
authors.lastname: Titulaer
authors.affiliation: Department of Nuclear Medicine, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Tjeerd S
authors.initials: TS
authors.lastname: Aukema
authors.affiliation: Department of Nuclear Medicine, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Renato A
authors.initials: RA
authors.lastname: Valdés Olmos
authors.affiliation: Department of Biometrics, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
authors.forename: Karolina
authors.initials: K
authors.lastname: Sikorska
authors.affiliation: Department of Surgical Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
authors.forename: Houke M
authors.initials: HM
authors.lastname: Klomp
authors.affiliation: Department of Surgery, Spaarne Gasthuis, Haarlem, The Netherlands.
authors.forename: Herman
authors.initials: H
authors.lastname: Rijna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001692:Biological Transport; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D011379:Prognosis; D016019:Survival Analysis
chemical_list: D019788:Fluorodeoxyglucose F18; D005947:Glucose
keywords: Early stage; Non-small cell lung cancer; PET/CT; Prognostic; Surgery