Author of

• 16751

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  P1.05 - Poster Session with Presenters Present (ID 457)

  • Event: WCLC 2016
  • Type: Poster Presenters Present
  • Track: Early Stage NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 12/05/2016, 14:30 - 15:45, Hall B (Poster Area)

  • 16808

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    P1.05-057 - Prediction of Early Recurrence in Patients with Stage I and II Non-Small Cell Lung Cancer Using FDG PET Quantification (ID 4872)

    14:30 - 15:45  |  Author(s): B. Sick
    • Abstract

    Background:
    Although surgical resection remains the optimal treatment for early-stage NSCLC, up to 50% of patients with stage I and II relapse and die within 5 years after curative resection. Therefore prognostic markers are important as these patients might benefit from adjuvant therapy. The goal of this study was to evaluate established PET quantification metrics including: maximal standard uptake volume (SUV~max~), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) as prognostic markers for early recurrence and overall survival in resected early stage lung cancer.
    
    Methods:
    Between January 2003 and December 2010 182 surgically resected patients with stage I-II NSCLC who underwent 18 F FDG PET/CT less than one month prior to surgery have been evaluated. All patients had at least 5 years of follow-up. Cox proportional hazard model was used to determine the association between variables and survival respectively time to recurrence. For the multivariate analysis the following variables have been included: tumor size on CT, age tumor stage, histology, SUV~max~, TLG (for TLG~42%~ (threshold at 42% SUV~max~) and TLG~2.5 ~(cut-off at SUV 2.5) and MTV~42%~ and MTV~2.5~). To identify high-risk patients we used survival trees.
    
    Results:
    133 patients were included, 71 with adeno carcinoma, 62 with squamous cell carcinoma. TLG~2.5~ and MTV~2.5~ values have been a significant prognostic factor for recurrence (P<0.0001). Patients with a MTV2.5 above 42 cm[3] had a mean recurrence time of 0.8±0.9 years, while patients with MTV2.5 ≤ 42 cm[3 ]recurred within 2.8±1.3 years. Using the survival tree models TLG~42%~ has been the first choice variable for discriminating high risk patients for DOD (dead of disease) independent from histological type, whereas MTV~2.5~ has been the first choice for DOD in adeno carcinoma patients.
    
    Conclusion:
    TLG and MTV may be useful prognostic variables in stage I-II NSCLC depending on the tumor type. Using a cut-off at 42 cm[3 ]for early stage adenocarcinoma patients a high risk of recurrence within one year might be identified and adjuvant therapy following surgical resection could improve outcome for those patients.