Developing and validating a novel metabolic tumor volume risk stratification system for supplementing non-small cell lung cancer staging.
Developing and validating a novel metabolic tumor volume risk stratification system for supplementing non-small cell lung cancer staging.
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DOI：
10.1007/s00259-018-4059-3
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发表时间：
2018-11
影响因子：
9.1
通讯作者：
Penney BC
中科院分区：
文献类型：
--
作者：
Pu Y;Zhang JX;Liu H;Appelbaum D;Meng J;Penney BC
我们假设，全身代谢肿瘤体积（MTV）可用于补充非小细胞肺癌（NSCLC）分期，由于其独立的预后价值。本研究的目的是开发和验证一种新的MTVEGFR1风险分层系统，以补充NSCLC分期。我们对935例NSCLC和FDG avid肿瘤患者进行了IRB批准的回顾性审查，根据用于成像的PET/CT扫描仪类型分为建模和验证队列。此外，通过将患者人群分为两个随机队列进行敏感性分析。进行考克斯回归和Kaplan-Meier生存分析，以确定MTVT危险分层系统的预后价值。建模队列的MTVwb四分位数之间的截止值（10.0、53.4和155.0 mL）应用于建模和验证队列，以确定每位患者的MTVwb风险分层。生存分析显示，MTV风险分层越低，总生存率越高（所有p <0.01），与TNM分期以及其他临床预后因素无关，并且MTV风险分层系统的区分能力（由Gonen和Heller一致性指数测量）与两个队列的TNM分期无显著差异。此外，MTV风险分层的预后价值在两个随机队列中是稳健的。MTV风险分层与TNM分期或亚期之间的不一致率在建模中为45.1%，在验证队列中为50.3%。本研究开发并验证了一种新的MTVEGFR4风险分层系统，该系统具有独立于NSCLC TNM分期和其他临床预后因素的预后价值，表明其可用于进一步NSCLC预处理评估和改善患者的治疗决策。
We hypothesized that whole-body metabolic tumor volume (MTVwb) could be used to supplement non-small cell lung cancer (NSCLC) staging due to its independent prognostic value. The goal of this study was to develop and validate a novel MTVwb risk stratification system to supplement NSCLC staging. We performed an IRB-approved retrospective review of 935 patients with NSCLC and FDG avid tumor divided into modeling and validation cohorts based on the PET/CT scanner type used for imaging. In addition, sensitivity analysis was conducted by dividing the patient population into two randomized cohorts. Cox regression and Kaplan-Meier survival analyses were performed to determine the prognostic value of the MTVwb risk stratification system. The cutoff values (10.0, 53.4 and 155.0 mL) between the MTVwb quartiles of the modeling cohort were applied to both modeling and validation cohorts to determine each patient’s MTVwb risk stratum. The survival analyses showed that a lower MTVwb risk stratum was associated with better overall survival (all p<0.01), independent of the TNM stage together with other clinical prognostic factors, and the discriminatory power of the MTVwb risk stratification system, as measured by Gonen and Heller’s concordance index, was not significantly different from that of TNM stage in both cohorts. Also, the prognostic value of the MTVwb risk stratum was robust in the two randomized cohorts. The discordance rate between the MTVwb risk stratum and TNM stage or substage was 45.1% in the modeling and 50.3% in the validation cohorts. This study developed and validated a novel MTVwb risk stratification system, which has prognostic value independent of the TNM stage and other clinical prognostic factors in NSCLC, suggesting it can be used for further NSCLC pretreatment assessment and for refining patient’s treatment decisions.
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影响因子：
19.7
作者：
Zhang C;Liao C;Penney BC;Appelbaum DE;Simon CA;Pu Y
通讯作者：
Pu Y
DOI：
10.1007/s00259-014-2903-7
发表时间：
2015-02-01
影响因子：
9.1
作者：
Im, Hyung-Jun;Pak, Kyoungjune;Lee, Dong Soo
通讯作者：
Lee, Dong Soo
DOI：
10.1007/s00259-011-1934-6
发表时间：
2012-01-01
影响因子：
9.1
作者：
Liao, Shengri;Penney, Bill C.;Pu, Yonglin
通讯作者：
Pu, Yonglin
影响因子：
4.8
作者：
Zhang, Hao;Wroblewski, Kristen;Pu, Yonglin
通讯作者：
Pu, Yonglin
影响因子：
20.4
作者：
Goldstraw, Peter;Chansky, Kari;Bolejack, Vanessa
通讯作者：
Bolejack, Vanessa