Prognostic Significance of [¹⁸F]-Fluorodeoxyglucose Uptake on Positron Emission Tomography in Patients with Pathological Stage I Lung Adenocarcinoma

Although patients with stage II or III non-small cell lung cancer (NSCLC) can generally be considered candidates for postoperative chemotherapy, it is still difficult to determine whether it would be useful for patients with stage I after complete resection. To determine the potential usefulness of postoperative adjuvant chemotherapy in patients with stage I NSCLC, it is important to clarify the prognostic factors in these patients.

In recent years, [¹⁸F]fluoro-2-deoxyglucose uptake on positron emission tomography (FDG-PET) has been frequently used for diagnosis and staging of lung cancer (Gould et al., 2001; Marom et al., 2002; Nomori et al., 2004a). It has also been reported that FDG uptake on PET can be a prognostic factor in patients with NSCLC (Cerfolio et al., 2005; Vansteenkiste et al., 1999). However, FDG uptake is dependent on the histological cell type of NSCLC, i.e., FDG uptake by adenocarcinoma is correlated with pathological tumor stage and tumor invasiveness, whereas that of other histological types is not (Nomori et al., 2004a; Sagawa et al., 2006). Therefore, we consider that the prognostic significance of FDG uptake should be examined in adenocarcinomas, but not in NSCLC including all histological types. Therefore, in the present study, we examined the prognostic significance of FDG uptake in patients with pathological stage I lung adenocarcinoma.