title: Prognostic value of quantitative PET/CT in patients with a nonsmall cell lung cancer and another primary cancer.
abstract: OBJECTIVE
  The staging and management of patients with newly diagnosed nonsmall cell lung cancer (NSCLC) in the setting of recently diagnosed other (metachronous or synchronous) primary cancer are challenging. This retrospective cohort study was carried out to test our hypothesis that baseline 2-deoxy-2-[F]fluoro-D-glucose (F-FDG) PET/CT parameters, including whole-body metabolic tumor volume (MTVWB), total lesion glycolysis (TLGWB), and maximum standardized uptake value (SUVmaxWB), are associated with the overall survival (OS) of such patients.
  
  
  METHODS
  A total of 110 NSCLC patients (52 men and 58 women, aged 68.6±7.8 years) with other primary malignant cancers who had baseline F-FDG PET/CT scans were retrospectively reviewed. MTVWB, TLGWB, and SUVmaxWB were measured. Kaplan-Meier analysis with the log-rank test and Cox regression models were used to assess the association of OS with F-FDG PET/CT parameters and clinical risk factors.
  
  
  RESULTS
  Kaplan-Meier analysis and univariate Cox regression models showed significant associations of OS with ln(MTVWB), ln(TLGWB), ln(SUVmaxWB), TNM stage, and treatment type (surgery vs. no treatment). Multivariable Cox regression models showed a significant relationship of OS with ln(MTVWB) [hazard ratio (HR)=1.368, P=0.001], ln(TLGWB) (HR=1.313, P<0.001), and ln(SUVmaxWB) (HR=1.739, P=0.006), adjusted for age, treatment type, tumor histology, and TNM stage. The TNM stage was not associated significantly with OS when MTVWB, TLGWB, or SUVmaxWB were included in the multivariable models.
  
  
  CONCLUSIONS
  MTVWB, TLGWB, and SUVmaxWB from baseline F-FDG PET/CT are associated individually with OS of patients with both NSCLC and other primary malignant tumors independent of age, treatment type, tumor histology, and TNM stage.
authors.affiliation: aDepartment of Radiology, BenQ Medical Centre, Nanjing Medical University, Nanjing, Jiangsu Province bDepartment of Nuclear Medicine, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China Departments of cPublic Health Sciences dRadiology eSurgery fCancer Registry, University of Chicago gDepartment of Radiation and Cellular Oncology, University of Chicago Hospitals, Chicago, Illinois, USA.
authors.forename: Xuee
authors.initials: X
authors.lastname: Zhu
authors.forename: Chuanhong
authors.initials: C
authors.lastname: Liao
authors.forename: Bill C
authors.initials: BC
authors.lastname: Penney
authors.forename: Feng
authors.initials: F
authors.lastname: Li
authors.forename: Mark K
authors.initials: MK
authors.lastname: Ferguson
authors.forename: Cassie A
authors.initials: CA
authors.lastname: Simon
authors.forename: Tianming
authors.initials: T
authors.lastname: Wu
authors.forename: Haiyan
authors.initials: H
authors.lastname: Liu
authors.forename: Yonglin
authors.initials: Y
authors.lastname: Pu
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000401:mortality; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging* / Q000401:mortality; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods* / Q000706:statistics & numerical data; D011379:Prognosis; D016016:Proportional Hazards Models; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18