Prognostic Value of Combing Primary Tumor and Nodal Glycolytic–Volumetric Parameters of <sup>18</sup>F-FDG PET in Patients with Non-Small Cell Lung Cancer and Regional Lymph Node Metastasis
Yu-Hung Chen,
Sung-Chao Chu,
Ling-Yi Wang,
Tso-Fu Wang,
Kun-Han Lue,
Chih-Bin Lin,
Bee-Song Chang,
Dai-Wei Liu,
Shu-Hsin Liu,
Sheng-Chieh Chan
Affiliations
Yu-Hung Chen
Department of Nuclear Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
Sung-Chao Chu
School of Medicine, College of Medicine, Tzu Chi University, Hualien 97002, Taiwan
Ling-Yi Wang
Epidemiology and Biostatistics Consulting Center, Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Department of Pharmacy, School of Medicine, Tzu Chi University, Hualien 97002, Taiwan
Tso-Fu Wang
School of Medicine, College of Medicine, Tzu Chi University, Hualien 97002, Taiwan
Kun-Han Lue
Department of Medical Imaging and Radiological Sciences, Tzu Chi University of Science and Technology, Hualien 97005, Taiwan
Chih-Bin Lin
School of Medicine, College of Medicine, Tzu Chi University, Hualien 97002, Taiwan
Bee-Song Chang
Department of Cardiothoracic Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
Dai-Wei Liu
School of Medicine, College of Medicine, Tzu Chi University, Hualien 97002, Taiwan
Shu-Hsin Liu
Department of Nuclear Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
Sheng-Chieh Chan
Department of Nuclear Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
We investigated whether the combination of primary tumor and nodal 18F-FDG PET parameters predict survival outcomes in patients with nodal metastatic non-small cell lung cancer (NSCLC) without distant metastasis. We retrospectively extracted pre-treatment 18F-FDG PET parameters from 89 nodal-positive NSCLC patients (stage IIB–IIIC). The Cox proportional hazard model was used to identify independent prognosticators of overall survival (OS) and progression-free survival (PFS). We devised survival stratification models based on the independent prognosticators and compared the model to the American Joint Committee on Cancer (AJCC) staging system using Harrell’s concordance index (c-index). Our results demonstrated that total TLG (the combination of primary tumor and nodal total lesion glycolysis) and age were independent risk factors for unfavorable OS (p p = 0.001) and PFS (both p p = 0.022). Our models based on the independent prognosticators outperformed the AJCC staging system (c-index = 0.732 versus 0.544 for OS and c-index = 0.672 versus 0.521 for PFS, both p < 0.001). Our results indicate that incorporating total TLG with clinical factors may refine risk stratification in nodal metastatic NSCLC patients and may facilitate tailored therapeutic strategies in this patient group.
