Primary tumor standardized uptake value (SUVmax) measured on 18 F-FDG PET/CT and mixed NSCLC components predict survival
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ORIGINAL ARTICLE – CLINICAL ONCOLOGY
Primary tumor standardized uptake value (SUVmax) measured on 18F‑FDG PET/CT and mixed NSCLC components predict survival in surgical‑resected combined small‑cell lung cancer Zhenzhen Hui1,3,4,5,6 · Feng Wei2,3,4,5,6 · Hongliang Ren8 · Wengui Xu3,4,7 · Xiubao Ren1,2,3,4,5,6 Received: 3 November 2019 / Accepted: 28 April 2020 © The Author(s) 2020
Abstract Purpose The combined small-cell lung cancer (c-SCLC) is rare and has unique clinicopathological futures. The aim of this study is to investigate 18F-FDG PET/CT parameters and clinicopathological factors that influence the prognosis of c-SCLC. Methods Between November 2005 and October 2014, surgical-resected tumor samples from c-SCLC patients who received preoperative 18F-FDG PET/CT examination were retrospectively reviewed. The maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) were used to evaluate metabolic parameters in primary tumors. The survivals were evaluated with the Kaplan–Meier method. Univariate and multivariate analyses were used to evaluate potential prognostic factors. Results Thirty-one patients were enrolled, with a median age of 62 (range: 35 − 79) years. The most common mixed component was squamous cell carcinoma (SCC, n = 12), followed by large-cell carcinoma (LCC, n = 7), adenocarcinoma (AC, n = 6), spindle cell carcinoma (n = 4), adenosquamous carcinoma (n = 1) and atypical carcinoid (n = 1). The median follow-up period was 53.0 (11.0–142.0) months; the 5-year overall survival (OS) and progression-free survival(PFS) rate were 48.4% and 35.5%, respectively. Univariate survival analysis showed that gender, smoking history, tumor location were associated with PFS (P = 0.036, P = 0.043, P = 0.048), SUVmax and TNM stage were closely related to PFS in both Mixed SCC and non-SCC component groups (P = 0.007, P = 0.048). SUVmax, smoking history, tumor size and mixed SCC component were influencing factors of OS in patients (P = 0.040, P = 0.041, P = 0.046, P = 0.029). Multivariate survival analysis confirmed that TNM stage (HR = 2.885, 95%CI: 1.323–6.289, P = 0.008) was the most significantly influential factor for PFS. High SUVmax value (HR = 9.338, 95%CI: 2.426–35.938, P = 0.001) and mixed SCC component (HR = 0.155, 95%CI: 0.045–0.530, P = 0.003) were poor predictors for OS. Conclusion Surgical-resected c-SCLCs have a relatively good prognosis. TNM stage is the most significant factor influencing disease progression in surgical-resected c-SCLCs. SUVmax and mixed NSCLC components within c-SCLCs had a considerable influence on the survival. Both high SUVmax and mixed SCC component are poor predictors for patients with c-SCLCs. Keywords 18F-FDG PET/CT · c-SCLC · TNM stage · SUVmax · SCC · PFS · Overall survival
* Wengui Xu [email protected]
4
Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, People’s Republic of China
* Xiubao Ren [email protected]
5
Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, People’s R
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