The Prognostic Significance of Metabolic Tumor Volume and Total Lesion Glycolysis Measured by 18F-FDG PET/CT in Patients with NSCLC
Received Date : 14 Oct 2021
Accepted Date : 10 Nov 2021
Available Online : 18 Nov 2021
Sibel GÖKSELa, Arzu CENGİZb, Hakan ÖZTÜRKc, Yakup YÜREKLİb
aDepartment of Nuclear Medicine, Recep Tayyip Erdoğan University Faculty of Medicine, Rize, TURKEY
bDepartment of Nuclear Medicine, Aydın Adnan Menderes University Faculty of Medicine, Aydın, TURKEY
cDepartment of Biostatistic, Aydın Adnan Menderes University Faculty of Medicine, Aydın, TURKEY
Doi: 10.37047/jos.2021-86651 - Article's Language: EN
J Oncol Sci. 2021;7(3):150-8
ABSTRACT
Objective: This study aimsto determine the prognostic value of metabolic volumetric 18F-fluorodeoxyglucose positron emission
tomography/computed tomography (PET/CT) parameters of the primary tumor, including metabolic tumor volume (MTV) and total lesion
glycolysis (TLG) in patients with non-small cell lung cancer (NSCLC) patients. Material and Methods: The study included a total of
102 patients who underwent PET/CT for staging. Histopathological diagnosis, stage of disease, survival time, maximum standard uptake
value, MTV, and TLG values of the primary tumor were documented. The Kaplan-Meier test was used to examine the relationships between
overall survival (OS) with PET/CT parameters and Tumor-Node-Metastasis stages. Univariate and multivariate Cox regression analyses were
applied, and the association between OS with metabolic volumetric PET/CT parameters was estimated. Results: During the follow-up period,
93 (91.17%) patients died. All patients had a median OS of 10.15 months (range 0.5-74 months), whereas patients with M1 disease had a median
OS of 7 months (range 0.5-56 months). The majority of (79.41%) patients had advanced-stage disease. Statistically, the mean MTV
(p=0.012) and TLG (p=0.037) values at the early stage (Stage I-II) were significantly lower than the locally advanced and advanced (Stage
III-IV) stage. In univariate analysis, elder age (p=0.004), advanced stage (p<0.001), lack of the operable (p<0.001), high MTV (p<0.001), and
TLG (p<0.001) values were significantly correlated with poor OS. In multivariate analysis, stage of the disease (p<0.05), age (p=0.004), operable
(p=0.022), and TLG (p=0.0019) values were found to be the independent predictors for OS. Conclusion: In patients with NSCLC, MTV
and TLG of the primary tumor are suitable parameters to predict prognosis at first diagnosis. Particularly high level of TLG was independently
related to poor prognosis.
Keywords: Positron-emission tomography; survival rate; non-small cell lung carcinoma