Abstract 4697: SUV max of primary lung tumor on FDGPET/CT scan at baseline as a potential prognostic factor in stage IV NSCLC: a retrospective review.
Authors: Kodali Manga Devi , Takalkar Amol , Shi Runhua , Jafri Syed H. 
Published: August 2014

Purpose: To determine whether SUV max(Maximum Standardized Uptake Value) of primary lung tumor on FDGPET/CT scan (Fluorodeoxy Glucose -Positron Emission Tomography/Computed Tomography) at baseline has any role in predicting survival in patients with Stage IV NSCLC.

Background: Lung Cancer is the leading cause of mortality in both sexes in United States and Worldwide. About 70% of patients with lung cancer present with locally advanced or metastatic disease at diagnosis. In general Stage IV Lung cancer has poor prognosis with 5-year survival of 2 percent.

Limited numbers of factors are known to predict survival in Stage IV Lung cancer. Prognosis in Lung cancer is directly related to the stage at diagnosis, performance status, and genomic expression profile. Earlier studies have found SUV max of primary lung tumor on FDGPET/CT scan in early stage lung cancer correlates with tumor doubling time and survival. However prior studies performed in advanced stage lung cancer yielded conflicting data and most of the studies included StageIII/IVNSCLC patients. Hence we performed a retrospective review on patients with Stage IVNSCLC.

Patients and Methods: Retrospective review identified 46 patients between September 2004- September 2011 that were diagnosed with stage IV NSCLC at our institution who underwent FDGPET/CT scan at diagnosis .Extensive clinical data including tumor histologic type, clinical stage at presentation, number of metastatic sites,performance status and treatment were recorded. SUVmax in primary tumor on FDG PET/CT scan was determined on the attenuated-corrected FDG PET images utilizing an automated program on a dedicated PET/CT workstation by a single nuclear medicine specialist. Cox regression analysis and Log rank test were used for data analysis.

Results: Descriptive statistics showed Median age 61.6(43.8-77.8), Females 17(36%), African Americans 26(56%), Performance status(0-1)36(80%),number of metastatic sites(1-2)30(65%),Adenocarcinoma 32(70%),Chemotherapy 31(61%).The patient population was subdivided into two groups using the median SUVmax of 15.4. Median OS was 8.8months (95%CI, 5-13months). The median survival of patients having SUV max ≤15.4 and SUVmax &gt; 15.4 was 10.5 months(95%CI, 3.5-15.8months) and 6.0 months (95%CI,4.1-12.6months)respectively(P =0.127)

Multivariate analysis indicated that performance status (HR=3.1) and use of chemotherapy (HR=2.8) predicted survival. We did not find gender, race and histology to be a predictor of survival. We found SUV max&gt;15.4 has increased risk of death by 70% (HR=1.7, P=0.12)

Conclusion: Survival difference based on SUV max value of primary lung tumor on FDGPET/CT scan in patients with Stage IV NSCLC did not reach statistical significance but there was a trend towards improved survival in patients with SUVmax≤15.4. Future studies with a larger sample may be required to evaluate this trend.

Citation Format: Manga Devi Kodali, Amol Takalkar, Runhua Shi, Syed H. Jafri. SUV max of primary lung tumor on FDGPET/CT scan at baseline as a potential prognostic factor in stage IV NSCLC: a retrospective review. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4697. doi:10.1158/1538-7445.AM2013-4697