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Use of a prognostic risk score that aggregates the FDG-PET/CT SUVmax, tumor size, and histologic group for predicting the prognosis of pStage I lung adenocarcinoma

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Abstract

Background

pStage I includes clinicopathologically diverse groups. This study aimed to identify the prognostic factors for pStage I lung adenocarcinoma.

Methods

We retrospectively reviewed 208 patients with pStage I adenocarcinomas who underwent curative resection in our institute between 2006 and 2013. The maximum standardized uptake value (SUVmax) on [F18]-fluoro-deoxy-d-glucose positron emission tomography-computed tomography (PET/CT) was evaluated. Adenocarcinomas were categorized into the following histologic groups: group 0 (minimally invasive adenocarcinoma and lepidic predominant adenocarcinoma), group 1 (papillary predominant adenocarcinoma), and group 2 (acinar predominant adenocarcinoma and all the remaining subtypes). We assessed the relationship between disease-free survival (DFS) and clinicopathological factors.

Results

Multivariate analysis of DFS demonstrated that SUVmax > 3.0 (p < 0.001), total tumor size > 20 mm (p = 0.016), and histologic groups (p < 0.05) were independent prognostic factors. The prognostic risk score (PRS) was calculated using the following equation: PRS = SUVmax (≤ 3.0: 0 point, > 3.0: 2 points) + total tumor size (≤ 20 mm: 0 point, > 20 mm: 1 point) + histologic group (group 0: 0 point, group 1: 1 point, group 2: 2 points). Patients were divided into the following three risk groups: low-risk (PRS 0–2 points, n = 136), intermediate-risk (PRS 3–4 points, n = 49), and high-risk groups (PRS 5 points, n = 13). The 5-year DFS rates were 93.2%, 50.6%, and 30.8% for the low-, intermediate-, and high-risk groups, respectively (p < 0.001).

Conclusions

The PRS aggregating the FDG-PET/CT SUVmax, total tumor size, and histologic group predicts the prognosis of pStage I lung adenocarcinoma.

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Authors and Affiliations

  1. Department of Thoracic and Endocrine Surgery and Oncology, Institute of Biomedical Sciences, The University of Tokushima Graduate School, 3-18-15, Kuramoto-cho, Tokushima, 770-8503, Japan

    Naoya Kawakita, Hiroaki Toba, Yukikiyo Kawakami, Hiromitsu Takizawa, Daisuke Matsumoto, Mika Takashima, Mitsuhiro Tsuboi, Mitsuteru Yoshida & Akira Tangoku

  2. Division of Pathology, Tokushima University Hospital, Tokushima, Japan

    Yoshimi Bando

  3. Department of Medical Imaging/Nuclear Medicine, Institute of Biomedical Sciences, The University of Tokushima Graduate School, Tokushima, Japan

    Hideki Otuska

  4. Department of Oncological Medical Services, Graduate School of Biomedical Biosciences, Tokushima University, Tokushima, Japan

    Kazuya Kondo

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  1. Naoya Kawakita
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Correspondence to Hiroaki Toba.

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Supplementary file1 (DOCX 21 kb)

10147_2020_1637_MOESM2_ESM.tif

Online Resource 2. Relationship between the prognostic risk score and OS. The 5-year OS rates were 97.5%, 75.9%, and 44.9% for the low-risk group, intermediate-risk group, and high-risk group, respectively. Significant differences were observed between the low- and intermediate-risk groups and between the low- and high-risk groups (p < 0.05). OS = overall survival

Online Resource 3 Cumulative incidence of recurrence by the prognostic risk score

Supplementary file4 (DOCX 14 kb)

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Kawakita, N., Toba, H., Kawakami, Y. et al. Use of a prognostic risk score that aggregates the FDG-PET/CT SUVmax, tumor size, and histologic group for predicting the prognosis of pStage I lung adenocarcinoma. Int J Clin Oncol 25, 1079–1089 (2020). https://doi.org/10.1007/s10147-020-01637-6

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  • DOI: https://doi.org/10.1007/s10147-020-01637-6

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