Evaluation of maximum standardized uptake value at fluorine-18 fluorodeoxyglucose positron emission tomography as a complementary T factor in the eighth edition of lung cancer stage classification

Hyungjin Kim, Jin Mo Goo, Jin Chul Paeng, Young Tae Kim, Chang Min Park

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objectives: This retrospective cohort study aimed to analyze the prognostic effect of maximum standardized uptake value (SUVmax) as a complementary T factor in addition to the clinical T category of the eighth-edition staging system for the prediction of disease-free survival (DFS) in patients with resected lung adenocarcinomas. Materials and methods: A total of 572 patients (male:female = 235:337; median age, 64 years) with clinical stage I (T1-T2aN0M0) adenocarcinomas underwent preoperative fluorine-18 fluorodeoxyglucose positron emission tomography and subsequent lobectomy between 2009 and 2015. The prognostic values of SUVmax and PETT category [categorized SUVmax; PETT1 (SUVmax ≤2), PETT2 (2< SUVmax ≤7), and PETT3 (SUVmax >7)] in conjunction with the clinical T category were analyzed using a multivariable Cox regression and a likelihood-ratio test, respectively. The clinical T category was then upstaged or downstaged (cTModified) based on PETT. This new categorization system was evaluated using a Cox regression and then compared with the clinical T category. Results: Multivariable-adjusted Cox regression revealed that SUVmax and PETT were independent and significant predictors with the current clinical T category for DFS. Regarding SUVmax, the adjusted hazard ratio (HR) was 1.048 (95% CI: 1.009, 1.089; P = 0.017). Regarding PETT, the adjusted HRs were 2.365 (95% CI: 1.034, 5.406; P = 0.041) in PETT2 and 3.005 (95% CI: 1.258, 7.179; P = 0.013) in PETT3. The inclusion of the PET-derived factors substantially improved the model fit (P < 0.05). cTModified was a significant predictor of DFS, which improved the prognostic discrimination of lung adenocarcinomas. Conclusion: SUVmax and PETT are independent prognostic factors after adjustment for the clinical T category. The PETT category could be used to adjust the clinical T category preoperatively.

Original languageEnglish
Pages (from-to)151-157
Number of pages7
JournalLung Cancer
Volume134
DOIs
StatePublished - 1 Aug 2019

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Fluorodeoxyglucose F18
Positron-Emission Tomography
Lung Neoplasms
Disease-Free Survival
2-phenyl-6-(2'-(4'-(ethoxycarbonyl)thiazolyl))thiazolo(3,2-b)(1,2,4)triazole
Adenocarcinoma
Cohort Studies
Retrospective Studies

Keywords

  • Adenocarcinoma
  • Neoplasm staging
  • Positron emission tomography computed tomography
  • Standardized uptake value
  • T category

Cite this

@article{2ec18b2b226b40138cf123b84c134413,
title = "Evaluation of maximum standardized uptake value at fluorine-18 fluorodeoxyglucose positron emission tomography as a complementary T factor in the eighth edition of lung cancer stage classification",
abstract = "Objectives: This retrospective cohort study aimed to analyze the prognostic effect of maximum standardized uptake value (SUVmax) as a complementary T factor in addition to the clinical T category of the eighth-edition staging system for the prediction of disease-free survival (DFS) in patients with resected lung adenocarcinomas. Materials and methods: A total of 572 patients (male:female = 235:337; median age, 64 years) with clinical stage I (T1-T2aN0M0) adenocarcinomas underwent preoperative fluorine-18 fluorodeoxyglucose positron emission tomography and subsequent lobectomy between 2009 and 2015. The prognostic values of SUVmax and PETT category [categorized SUVmax; PETT1 (SUVmax ≤2), PETT2 (2< SUVmax ≤7), and PETT3 (SUVmax >7)] in conjunction with the clinical T category were analyzed using a multivariable Cox regression and a likelihood-ratio test, respectively. The clinical T category was then upstaged or downstaged (cTModified) based on PETT. This new categorization system was evaluated using a Cox regression and then compared with the clinical T category. Results: Multivariable-adjusted Cox regression revealed that SUVmax and PETT were independent and significant predictors with the current clinical T category for DFS. Regarding SUVmax, the adjusted hazard ratio (HR) was 1.048 (95{\%} CI: 1.009, 1.089; P = 0.017). Regarding PETT, the adjusted HRs were 2.365 (95{\%} CI: 1.034, 5.406; P = 0.041) in PETT2 and 3.005 (95{\%} CI: 1.258, 7.179; P = 0.013) in PETT3. The inclusion of the PET-derived factors substantially improved the model fit (P < 0.05). cTModified was a significant predictor of DFS, which improved the prognostic discrimination of lung adenocarcinomas. Conclusion: SUVmax and PETT are independent prognostic factors after adjustment for the clinical T category. The PETT category could be used to adjust the clinical T category preoperatively.",
keywords = "Adenocarcinoma, Neoplasm staging, Positron emission tomography computed tomography, Standardized uptake value, T category",
author = "Hyungjin Kim and Goo, {Jin Mo} and Paeng, {Jin Chul} and Kim, {Young Tae} and Park, {Chang Min}",
year = "2019",
month = "8",
day = "1",
doi = "10.1016/j.lungcan.2019.06.013",
language = "English",
volume = "134",
pages = "151--157",
journal = "Lung Cancer",
issn = "0169-5002",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Evaluation of maximum standardized uptake value at fluorine-18 fluorodeoxyglucose positron emission tomography as a complementary T factor in the eighth edition of lung cancer stage classification

AU - Kim, Hyungjin

AU - Goo, Jin Mo

AU - Paeng, Jin Chul

AU - Kim, Young Tae

AU - Park, Chang Min

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Objectives: This retrospective cohort study aimed to analyze the prognostic effect of maximum standardized uptake value (SUVmax) as a complementary T factor in addition to the clinical T category of the eighth-edition staging system for the prediction of disease-free survival (DFS) in patients with resected lung adenocarcinomas. Materials and methods: A total of 572 patients (male:female = 235:337; median age, 64 years) with clinical stage I (T1-T2aN0M0) adenocarcinomas underwent preoperative fluorine-18 fluorodeoxyglucose positron emission tomography and subsequent lobectomy between 2009 and 2015. The prognostic values of SUVmax and PETT category [categorized SUVmax; PETT1 (SUVmax ≤2), PETT2 (2< SUVmax ≤7), and PETT3 (SUVmax >7)] in conjunction with the clinical T category were analyzed using a multivariable Cox regression and a likelihood-ratio test, respectively. The clinical T category was then upstaged or downstaged (cTModified) based on PETT. This new categorization system was evaluated using a Cox regression and then compared with the clinical T category. Results: Multivariable-adjusted Cox regression revealed that SUVmax and PETT were independent and significant predictors with the current clinical T category for DFS. Regarding SUVmax, the adjusted hazard ratio (HR) was 1.048 (95% CI: 1.009, 1.089; P = 0.017). Regarding PETT, the adjusted HRs were 2.365 (95% CI: 1.034, 5.406; P = 0.041) in PETT2 and 3.005 (95% CI: 1.258, 7.179; P = 0.013) in PETT3. The inclusion of the PET-derived factors substantially improved the model fit (P < 0.05). cTModified was a significant predictor of DFS, which improved the prognostic discrimination of lung adenocarcinomas. Conclusion: SUVmax and PETT are independent prognostic factors after adjustment for the clinical T category. The PETT category could be used to adjust the clinical T category preoperatively.

AB - Objectives: This retrospective cohort study aimed to analyze the prognostic effect of maximum standardized uptake value (SUVmax) as a complementary T factor in addition to the clinical T category of the eighth-edition staging system for the prediction of disease-free survival (DFS) in patients with resected lung adenocarcinomas. Materials and methods: A total of 572 patients (male:female = 235:337; median age, 64 years) with clinical stage I (T1-T2aN0M0) adenocarcinomas underwent preoperative fluorine-18 fluorodeoxyglucose positron emission tomography and subsequent lobectomy between 2009 and 2015. The prognostic values of SUVmax and PETT category [categorized SUVmax; PETT1 (SUVmax ≤2), PETT2 (2< SUVmax ≤7), and PETT3 (SUVmax >7)] in conjunction with the clinical T category were analyzed using a multivariable Cox regression and a likelihood-ratio test, respectively. The clinical T category was then upstaged or downstaged (cTModified) based on PETT. This new categorization system was evaluated using a Cox regression and then compared with the clinical T category. Results: Multivariable-adjusted Cox regression revealed that SUVmax and PETT were independent and significant predictors with the current clinical T category for DFS. Regarding SUVmax, the adjusted hazard ratio (HR) was 1.048 (95% CI: 1.009, 1.089; P = 0.017). Regarding PETT, the adjusted HRs were 2.365 (95% CI: 1.034, 5.406; P = 0.041) in PETT2 and 3.005 (95% CI: 1.258, 7.179; P = 0.013) in PETT3. The inclusion of the PET-derived factors substantially improved the model fit (P < 0.05). cTModified was a significant predictor of DFS, which improved the prognostic discrimination of lung adenocarcinomas. Conclusion: SUVmax and PETT are independent prognostic factors after adjustment for the clinical T category. The PETT category could be used to adjust the clinical T category preoperatively.

KW - Adenocarcinoma

KW - Neoplasm staging

KW - Positron emission tomography computed tomography

KW - Standardized uptake value

KW - T category

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U2 - 10.1016/j.lungcan.2019.06.013

DO - 10.1016/j.lungcan.2019.06.013

M3 - Article

VL - 134

SP - 151

EP - 157

JO - Lung Cancer

JF - Lung Cancer

SN - 0169-5002

ER -