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Prognostic value of positron emission tomography in resected stage IA non-small cell lung cancer

  • Nuclear Medicine
  • Published:
European Radiology Aims and scope Submit manuscript

A Correction to this article was published on 13 July 2021

This article has been updated

Abstract

Objectives

To investigate the role of PET in predicting the prognosis of resected stage IA non-small cell lung cancer (NSCLC) and planning individualized therapeutic strategies.

Methods

We retrospectively reviewed the data of patients who underwent surgical resection for lung cancer between January 2004 and December 2014. The clinical data, imaging characteristics of nodules, surgical approaches, and outcomes were analyzed.

Results

We evaluated 998 cases; 637 patients with pathological stage I disease were categorized as follows: stage IA1 (251 cases), stage IA2 (250 cases), and stage IA3 (136 cases). The mean follow-up period was 109 months. Significant differences were observed in sex, tumor differentiation, epidermal growth factor receptor mutation, smoking habits, lymphovascular space invasion, tumor size, maximum standard uptake value (SUVmax), and carcinoembryonic antigen level among the groups. Multivariable Cox regression revealed that ground-glass opacity ratio (hazard ratio (HR) = 0.001) and tumor SUVmax independently predicted the postoperative risk of relapse for stage IA3 NSCLC. The HR for SUVmax > 4 was 8.986 (p < 0.001). The 5-year overall survival (OS) rates were 87.2%, 92.9%, and 82.7%, and the 5-year disease-free survival (DFS) rates were 93.2%, 84.2%, and 70.51% for stage IA1, IA2, and IA3 NSCLC, respectively (both p < 0.001). OS and DFS rates were poor in stage IA3 NSCLC patients with an SUVmax uptake > 4 (OS, 71.0% and 92.2%; DFS, 50.2% and 87.3%, for SUVmax > 4 and ≤ 4, respectively; both p = 0.001).

Conclusions

SUVmax was a prognostic factor for resected stage IA NSCLC. Postoperative treatment may be considered for IA3 NSCLC with SUVmax > 4.

Key Points

• PET helps surgeons to assess patients with early-stage lung cancer.

• This retrospective study revealed that PET plays an influential role in predicting the prognosis of resected lung cancer.

• Better prognostication aids better planning of therapeutic strategies with diversification.

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Abbreviations

CEA:

Carcinoembryonic antigen

CI:

Confidence interval

DFS:

Disease-free survival

ECOG:

Eastern Cooperative Oncology Group of Performance Status

EGFR:

Epidermal growth factor receptor

GGO:

Ground-glass opacity

HR:

Hazard ratio

LN:

Lymph node

LVSI:

Lymphovascular space invasion

NCCN:

National Comprehensive Cancer Network

NSCLC:

Non-small cell lung cancer

OS:

Overall survival

SCC:

Squamous cell carcinoma

SUVmax:

Maximum standardized uptake value

TNM:

Tumor–Node–Metastasis

VPI:

Visceral pleural invasion

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Acknowledgements

We thank the support we received from the members of the Cancer Registry Group, Tri-Service General Hospital.

Funding

The authors state that this work has not received any funding.

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Authors and Affiliations

  1. Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, 325, Section 2, Cheng-Kung Road, Taipei, 114, Taiwan

    Hsiu-Ping Chou, Kuan-Hsun Lin, Hsu-Kai Huang, Ying-Yi Chen, Ti-Hui Wu, Shih-Chun Lee, Hung Chang & Tsai-Wang Huang

  2. Department of Nuclear Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Li-Fan Lin

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  1. Hsiu-Ping Chou
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Correspondence to Tsai-Wang Huang.

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The scientific guarantor of this publication is Tsai-Wang, Huang.

Conflict of interest

The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was not required for this study because it’s a retrospective observational study from the single-center database which has been certificated by the institutional Review Board/Ethics Committee of National Defense Medical Center, Tri-service general hospital.

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Institutional Review Board approval was obtained.

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• retrospective

• observational

• performed at one institution

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The original online version of this article was revised: Several values in table 3 were incorrect.

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Chou, HP., Lin, KH., Huang, HK. et al. Prognostic value of positron emission tomography in resected stage IA non-small cell lung cancer. Eur Radiol 31, 8021–8029 (2021). https://doi.org/10.1007/s00330-021-07801-4

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  • DOI: https://doi.org/10.1007/s00330-021-07801-4

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