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Ann Thorac Surg 2009;88:911-916. doi:10.1016/j.athoracsur.2009.05.083
© 2009 The Society of Thoracic Surgeons
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Ikenna C. Okereke
Michael S. Kent
Malcolm M. DeCamp
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Right arrow Lung - cancer

Original Articles: General Thoracic

Standard Uptake Value Predicts Survival in Non–Small Cell Lung Cancer

Ikenna C. Okereke, MDa,*, Sidhu P. Gangadharan, MDa, Michael S. Kent, MDa, Saila P. Nicotera, MDa, Changyu Shen, PhDb, Malcolm M. DeCamp, MDa

a Division of Cardiothoracic Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
b Division of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana

Accepted for publication May 28, 2009.

* Address correspondence to Dr Okereke, Department of Surgery, Section of Cardiothoracic Surgery, Indiana University School of Medicine, 545 Barnhill Dr, EH 215, Indianapolis, IN 46202 (Email: iokereke{at}iupui.edu).

Presented at the Forty-fifth Annual Meeting of The Society of Thoracic Surgeons, San Francisco, CA, Jan 26–28, 2009.

Background: Integrated [18F]fluorodeoxyglucose positron emission tomography–computed tomography (PET-CT) scan is a widely used modality in the evaluation of lung cancer. Our goal was to determine the ability of the standard uptake value (SUV) of the primary tumor (SUV-T) and regional lymph nodes (SUV-N) to predict survival.

Methods: From January 2005 through June 2007, 584 consecutive patients undergoing integrated PET-CT scan for suspected lung cancer were studied. Results of integrated PET-CT scans, including the maximum SUV-T and SUV-N, were recorded. A patient was defined as having a positive PET scan if the maximum SUV (T or N) was greater than 2.5. Overall survival was documented from clinical records and the Social Security Death Index. Cox regression analysis was used to evaluate the correlation between SUV and survival.

Results: Among patients with a positive PET scan (n = 329), both SUV-T and SUV-N were predictors of survival. As maximum SUV of the primary mass increased, survival decreased (hazard ratio, 1.05; p < 0.001). As maximum SUV of locoregional lymph nodes increased, survival also decreased (hazard ratio, 1.06; p < 0.001). Furthermore, among patients with no mediastinal disease identified by PET-CT scan, increased SUV-T continued to predict poor survival (hazard ratio, 1.06; p = 0.001).

Conclusions: Local and regional maximum SUVs defined by integrated PET-CT scanning have a strong correlation with survival in patients with non–small cell lung cancer. An elevated SUV is known preoperatively and may assist clinicians in stratifying patients at increased overall risk preoperatively.






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