Prognostic usefulness of maximum standardized uptake value on FDG-PET in surgically resected non-small-cell lung cancer

FDG uptake on positron emission tomography (PET) has been considered a prognostic indicator in non-small cell lung cancer (NSCLC). The aim of this study was to assess the clinical significance of maximum value of SUV (maxSUV) in recurrence prediction in patients with surgically resected NSCLC. NSCLC patients (n = 42, F:M = 14:28, age 62.3 ± 12.3 y) who underwent resection after FDG-PET were enrolled. Twenty-nine patients had pathologic stage I, and 13 had pathologic stage II. Thirty-one patients were additionally treated with adjuvant oral chemotherapy. MaxSUVs of primary tumors were analyzed for correlation with tumor recurrence and compared with pathologic or clinical prognostic indicator. The median follow-up duration was 16 mo (range, 3-26 mo). Ten (23.8%) of the 42 patients experienced recurrence during a median follow-up of 7.5 mo (range, 3-13 mo). Univariate analysis revealed that disease-free survival (DFS) was significantly correlated with maxSUV (< 7 vs. ≥ 7, ρ = 0.006), tumor size (< 3 cm vs. ≥ 3 cm, ρ = 0.024), and tumor cell differentiation (well/moderate vs. poor, ρ = 0.044). However, multivariate Cox proportional analysis identified maxSUV as the single determinant for DFS (ρ = 0.014). Patients with a maxSUV of ≥ 7 (n = 10) had a significantly lower 1-year DFS rate (50.0%) than those with a maxSUV of < 7 (n = 32, 87.5%). MaxSUV is a significant independent predictor for recurrence in surgically resected NSCLC. FDG uptake can be added to other well/known factors in prognosis prediction of NSCLC