Prognostic significance of volume-based ¹⁸F-FDG PET/CT parameter in patients with surgically resected non-small cell lung cancer

Summary

Aim: We investigated the prognostic value of volume-based ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) parameters compared with other factors including several immunohistochemical biomarkers in patients with surgically resected non-small cell lung cancer (NSCLC). Patients, methods: Study participants: 290 patients with surgically resected and histopathologically confirmed NSCLC. The maxmum standardized uptake value (SUV_max) and metabolic tumour volume (MTV) of the primary tumour were obtained on ¹⁸F-FDG PET/ computed tomography (CT) for initial staging and Ki-67 labeling index (LI), p16, CD31 and cyclin E were evaluated in the primary tumours by immunohistochemical staining. Survival analyses for variables including PET parameters, immunohistochemical biomarker and other clinical factors were performed using the Kaplan-Meier method and Cox proportional hazards regression analysis. Results: In univariate analyses, tumour stage, tumour size, and MTV were significant prognostic factors for decreased overall survival (OS) and disease-free survival (DFS). Multivariate analyses showed MTV and tumour stage were significant predictors of poor OS (MTV, hazard ratio (HR) = 1.135, p = 0.015; stage, HR = 0.644, p = 0.025) and DFS (MTV, HR = 1.128, p = 0.043; stage, HR = 0.541, p = 0.009). Conclusion: The MTV of primary tumours is a significant prognostic factor for survival along with tumour stage in patients with surgically resected NSCLC. The MTV can predict OS and DFS better than immuno histochemical biomarkers.

Zusammenfassung

Ziel: Wir untersuchten den prognostischen Stellenwert volumenbasierter Parameter der ¹⁸F-FDG-PET im Vergleich zu anderen Faktoren, darunter immunhistochemische Biomarker, bei Patienten mit operativ entfernten nicht-kleinzelligem Bronchialkarzinom (NSCLC). Patienten, Methoden: Studienteilnehmer: 290 Patienten mit operativ entfernten und histopathologisch gesicherten NSCLC. Im Rahmen des initialen Staging wurden der maximale standardisierte Uptake (SUV_max) und das metabolische Tumorvolumen (MTV) der Primärtumore mittels ¹⁸F-FDG PET/CT bestimmt; Ki-67 Markierungsindex (LI), p16, CD31 und Cyclin E wurden anhand immunhistochemischer Färbungen der Primärtumore beurteilt. Die Überlebensanalysen für die Variablen, u.a. PET-Parameter, immunhistochemische Biomarker und andere klinische Faktoren, erfolgten anhand der Kaplan-Meier-Methode sowie der Regressions-analyse nach Cox (proportionales Hazard-Modell). Ergebnisse: In univariaten Analysen waren Stadium und Größe des Tumors und MTV unabhängige prognostische Faktoren für ein geringeres Gesamtüberleben (OS) und krankheitsfreies Überleben (DFS). Multivariate Analysen weisen MTV und Tumorstadium als signifikante Prädiktoren für ein schlechtes OS (MTV: Hazard Ratio (HR) = 1,135, p = 0,015; Stadium: HR = 0,644, p = 0,025) und DFS (MTV: HR = 1,128, p = 0,043; Stadium: HR = 0,541, p = 0,009) aus. Schlussfolgerung: Bei Patienten mit operativ entfernten NSCLC ist das MTV der Primärtumore, zusammen mit dem Tumorstadium, ein bedeutender prognostischer Überlebensfaktor. Das MTV kann OS und DFS besser vorhersagen als immunhistochemische Biomarker.

Keywords

¹⁸F-FDG - PET/CT - lung cancer - metabolic tumour volume - immunohistochemical biomarkers

Schlüsselwörter

⁸F-FDG - PET/CT - Bronchialkarzinom - metabolisches Tumorvolumen - immunhistochemische Biomarker

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