Prognostic stratification model for patients with stage I non-small cell lung cancer adenocarcinoma treated with surgical resection without adjuvant therapies using metabolic features measured on F-18 FDG PET and postoperative pathologic factors
Prognostic stratification model for patients with stage I non-small cell lung cancer adenocarcinoma treated with surgical resection without adjuvant therapies using metabolic features measured on F-18 FDG PET and postoperative pathologic factors
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DOI：
10.1016/j.lungcan.2018.02.013
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发表时间：
2018-05-01
期刊：
影响因子：
5.3
通讯作者：
Kim, Sang Eun
中科院分区：
文献类型：
--
作者：
Kang, Yeon-koo;Song, Yoo Sung;Kim, Sang Eun
目的：在非小细胞肺癌（NSCLC）的管理中，无辅助治疗指征的I期肿瘤的预后分层仍有待阐明，以便更好地选择可从其他治疗中获益的患者。我们的目的是分层与I期非小细胞肺癌腺癌患者的预后，使用临床病理因素和F-18 FDG PET.Materials和方法：我们回顾性纳入128例I期非小细胞肺癌没有任何高危因素，谁接受根治性手术切除无辅助治疗。通过病历回顾评估术前临床和术后病理因素。在F-18 FDG PET上测量经瘦体重校正的标准化摄取值（SULmax）。在这些因素中，使用单变量和逐步多变量生存分析选择无复发生存期（RFS）的独立预测因子。RFS的预后分层模型设计使用选定的factors.Results：肿瘤复发19例（14.8%）。在研究的临床病理和FDG PET因素中，PET上的SULmax和病理检查上的气隙扩散（STAS）被确定为RFS的独立预后因素。以以下方式使用这两个因素设计预后模型：（1）低风险：SULmax）1.9和观察到的STAS。该模型表现出显着的预测能力RFS.Conclusion：我们表明，FDG摄取和STAS是重要的预后标志物在I期NSCLC腺癌手术切除治疗，没有辅助治疗。
Purpose: In the management of non-small cell lung cancer (NSCLC), the prognostic stratification of stage I tumors without indication of adjuvant therapy, remains to be elucidated in order to better select patients who can benefit from additional therapies. We aimed to stratify the prognosis of patients with stage I NSCLC adenocarcinoma using clinicopathologic factors and F-18 FDG PET.Materials and methods: We retrospectively enrolled 128 patients with stage I NSCLC without any high-risk factors, who underwent curative surgical resection without adjuvant therapies. Preoperative clinical and post-operative pathologic factors were evaluated by medical record review. Standardized uptake value corrected with lean body mass (SULmax) was measured on F-18 FDG PET. Among the factors, independent predictors for recurrence-free survival (RFS) were selected using univariate and stepwise multivariate survival analyses. A prognostic stratification model for RFS was designed using the selected factors.Results: Tumors recurred in nineteen patients (14.8%). Among the investigated clinicopathologic and FDG PET factors, SULmax on PET and spread through air spaces (STAS) on pathologic review were determined to be independent prognostic factors for RFS. A prognostic model was designed using these two factors in the following manner: (1) Low-risk: SULmax ) 1.9 and observed STAS. This model exhibited significant predictive power for RFS.Conclusion: We showed that FDG uptake and STAS are significant prognostic markers in stage I NSCLC adenocarcinoma treated with surgical resection without adjuvant therapies.