Prognostic Impact of FDG-PET in Surgically Treated Pathological Stage I Lung Adenocarcinoma

Purpose: This retrospective study evaluated whether the maximum standardized uptake value (SUVmax) on 18F-deoxyglucose (FDG)-positron emission tomography (PET) could be used to predict the prognosis of patients with pathological stage I adenocarcinoma. Methods: We analyzed 138 consecutive patients with pathological stage IA or IB lung adenocarcinoma except pure bronchioloalveolar carcinoma (BAC) who underwent pre-operative FDG-PET imaging and curative resection from January 2005 to October 2010. We analyzed associations between disease-free survival (DFS) and clinicopathological factors. Results: The 5-year DFS rate was 77.7%. Twenty two patients (15.9%) developed recurrence after surgery. Multivariate analysis identified SUVmax and lymphovascular (ly) involvement as the independent prognostic factors for recurrence (p = 0.0255 and p = 0.0333, respectively). We divided the patients into groups according to SUVmax and ly involvement. The 5-year DFS rate was 97.0% in patients with SUVmax <= 2.5 and without ly involvement, 100% with both SUVmax <= 2.5 and ly involvement, 70.2% with SUVmax >2.5 and without ly involvement, and 53.1% with both SUVmax >2.5 and ly involvement. Conclusions: The results of this study suggest that SUVmax and ly involvement could be used to predict the prognosis of patients with pathological stage I adenocarcinoma. The combination of these prognostic factors could also identify high risk groups of recurrence.