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High PET Uptake Value May Predict Relapses in Stage I NSCLC


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High PET Uptake Value May Predict Relapses in Stage I NSCLC

Researchers from Washington University have reported that the maximum tumor standardized uptake value (SUVmax) of preoperative positron emission tomography (PET) is a predictor of relapse in patients with Stage I non–small cell lung cancer (NSCLC). The details of this study appeared in the February, 2008 issue of the Journal of Thoracic Oncology.1

Lung cancer remains the leading cause of cancer-related deaths in industrialized countries. Once lung cancer spreads, long-term survival rates are poor. However, if lung cancer is detected and treated in its earliest stages—prior to spread—it can be highly curable. Therefore, efforts are underway to improve early detection of lung cancer so that long-term survival may also be improved.

Previous studies have shown that PET scans improve the accuracy of diagnosing lung cancer as well as the accuracy of staging prior to treatment.

The current study looked at whether or not the preoperative SUVmax was predictive of relapse in 136 patients with Stage I NSCLC. Thirty-two patients in this study relapsed after surgery. Patients were stratified as having an SUVmax below or above the median uptake value of 5.5. Patients who had an SUVmax greater than 5.5 had a five-year relapse rate of 37% compared with 14% for those with an SUVmax less than 5.5. Patients with an SUVmax greater than 5.5 had a five-year survival of 74% compared with 53% for those with an SUVmax less than 5.5. These authors suggest that the SUVmax may help select patients for adjuvant chemotherapy.

Comments: Adjuvant cisplatin-based chemotherapy is currently not recommended for routine use in patients with Stage IA NSCLC, and its benefits in Stage IB NSCLC are still uncertain. Adjuvant radiation therapy is not recommended for patients with Stage I–II NSCLC and may reduce survival. However, patients with Stage I NSCLC with a high SUVmax may be ideal candidates for evaluation of adjuvant chemotherapy in randomized trials.

Related News:

PET Scans May Help Identify Early Lung Cancer (12/03/2007)

PET Scans More Accurate in Detecting Mediastinal Lymph Node Metastasis in NSCLC (2/2/2005)

More Evidence that PET Scans are Better than CT Scans for Staging Lung Cancer (4/29/2004)

PET Scanning More Accurate Than CT for Staging of Mediastinum in Patients with NSCLC (12/4/2003)

Combined PET/CT Scan Improves Staging for NSCLC (11/11/2003)

CT Scans plus PET Scans Detect Early Lung Cancer in Heavy Smokers (8/26/2003)

Integrated PET-CT Improves Staging of Non-Small Cell Lung Cancer (6/24/2003)



1 Goodgame B, Pillot G, Yang Z, et al. Prognostic value of preoperative positron emission tomography in resected stage I non-small cell lung cancer. Journal of Thoracic Oncology. 2008;3:130-134.

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The Cancer Consultants article seems to erroneously reverse the findings from the actual study in regard to survival. When you go to the original article of the study results (in the Journal of Thoracic Oncology),it basically says the opposite - that patients with the higher SUVs on PET have lower survival...and that patients with the lower SUV results have better survival. This would be more consistent with everything I have read in the past on this topic. I think the Cancer Consultants piece accidentally reversed the language on the survival findings.

This is the excerpt from the original article in the Journal of Thoracic Oncology: The 5-year estimates of recurrence rates for patients with low and high SUVmax were 14% and 37%, respectively (p = 0.002), with 5-year overall survivals of 74% and 53%, respectively (p = 0.006).

Am I reading this wrong?


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