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High tumor metabolic activity as measured by fluorodeoxyglucose positron emission tomography is associated with poor prognosis in limited and extensive stage small-cell lung cancer.

 Young Joo Lee  ;  ArthurCho  ;  Byoung Chul Cho  ;  Mijin Yun  ;  Se Kyu Kim  ;  Joon Chang  ;  Jin WookMoon  ;  In Kyu Park  ;  HyeJin Choi  ;  Joo-Hang Kim 
 CLINICAL CANCER RESEARCH, Vol.15(7) : 2426-2432, 2009 
Journal Title
Issue Date
Aged ; Female ; Fluorodeoxyglucose F18* ; Humans ; Lung Neoplasms/diagnostic imaging* ; Lung Neoplasms/metabolism ; Lung Neoplasms/mortality* ; Male ; Middle Aged ; Positron-Emission Tomography* ; Prognosis ; Radiopharmaceuticals* ; Small Cell Lung Carcinoma/diagnostic imaging* ; Small Cell Lung Carcinoma/metabolism ; Small Cell Lung Carcinoma/mortality*
PURPOSE: We investigated the prognostic effect of incorporating metabolic assessment by (18)F-fluoro-2-deoxyglucose uptake on positron emission tomography/computed tomography ((18)F-FDG-PET/CT) into a conventional staging system in small-cell lung cancer (SCLC).

EXPERIMENTAL DESIGN: Seventy-six consecutive patients with pathologically proven SCLC were enrolled. All patients underwent standard treatment after pretreatment (18)F-FDG-PET/CT scanning. The mean values of maximal standardized uptake values (meanSUV(max)) of the malignant lesions upon (18)F-FDG-PET/CT were calculated. The Cox proportional hazards model was used with performance status, lactate dehydrogenase, stage, and meanSUV(max).

RESULTS: Patients with high meanSUV(max) were significantly related with the established poor prognostic factors, such as higher lactate dehydrogenase (P = 0.04) and extensive disease (ED; P = 0.01). Furthermore, in multivariate analysis, patients with high meanSUV(max) were associated with poor survival outcomes compared with patients with low meanSUV(max) [adjusted hazard ratio, 3.74; 95% confidence interval (95% CI), 1.67-8.37; P = 0.001, for death and adjusted hazard ratio, 2.25; 95% CI, 1.21-4.17; P = 0.01 for recurrence/progression]. In subgroup analysis, limited disease (LD) with high meanSUV(max) showed significantly shorter overall survival than LD with low meanSUV(max) [high versus low meanSUV(max), 20.1 months (95% CI, 7.9-23.2) versus 35.3 months (95% CI, 27.6-42.9); P = 0.02]. ED with high meanSUV(max) had significantly shorter overall survival than ED with low meanSUV(max) [high versus low meanSUV(max), 9.5 months (95% CI, 4.9-13.9) versus 17.7 months (95% CI, 12.0-20.1); P = 0.007]. These findings were replicated in progression-free survival analysis.

CONCLUSIONS: In SCLC, tumor metabolic activity as assessed by FDG-PET is a significant prognostic factor and identifies subgroups of patients at higher risk of death in both LD and ED SCLC.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Kyu(김세규)
Kim, Joo Hang(김주항)
Moon, Jin Wook(문진욱)
Park, In Kyu(박인규)
Yun, Mi Jin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Chang, Joon(장준) ORCID logo https://orcid.org/0000-0003-4542-6841
Cho, Byoung Chul(조병철) ORCID logo https://orcid.org/0000-0002-5562-270X
Cho, Arthur Eung Hyuck(조응혁) ORCID logo https://orcid.org/0000-0001-8670-2473
Choi, Hye Jin(최혜진) ORCID logo https://orcid.org/0000-0001-5917-1400
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