Prediction for Recurrence Using F-18 FDG PET/CT in Pathologic N0 Lung Adenocarcinoma After Curative Surgery

Abstract

Background

The aim of this study was to investigate risk factors for recurrence in patients with lung adenocarcinoma (LAD) who were pathologically N0 (pN0) after curative surgical resection.

Methods

A total of 102 LAD patients (M/F = 55/47, mean age, 62.6 ± 9.4 years) diagnosed as pN0 after curative surgery were included in this study. Clinical, biochemical, radiologic, and pathologic findings were reviewed and analyzed for recurrence. Metabolic parameters [SUVmax, metabolic tumor volume (MTV), total lesion glycolysis (TLG)] on pretreatment F-18 FDG PET/CT were also obtained and analyzed for recurrence.

Results

Of 102 patients, 38 (37.3 %) were found to experience recurrence for 33.6 ± 16.3 months. SUVmax, MTV, and TLG were significantly higher in patients with recurrence. The optimal cutoff values determined using a receiver-operating characteristic curve were 6.90 for SUVmax, 10.78 cm3 for MTV, and 39.68 for TLG. Univariate analysis showed that tumor size, tumor marker, SUVmax, MTV, and TLG were prognostic factors for recurrence. In multivariate analyses, after adjusting for age, sex, tumor size, pathologic T stage, and tumor marker, high SUVmax, MTV, and TLG showed an association with an increased risk of recurrence.

Conclusions

Metabolic parameters on pretreatment F-18 FDG PET/CT can predict recurrence in pN0 LAD patients who underwent curative surgery. Therefore, patients with high metabolic parameters on PET can be considered as candidates for adjuvant therapy to reduce recurrence and should be monitored carefully for early detection of possible recurrence.