Low Tumor Metabolic Activity Could Predict Survival in Stage I NSCLC

Low pre-surgery uptake of a labeled glucose analogue, a marker of metabolic activity, in the primary tumor of patients with stage I non-small cell lung cancer is associated with increased overall survival and a longer time before tumor recurrence, a study shows. Patients with high labeled glucose uptake may benefit from additional therapy following surgery.

Surgery is the standard of care for patients with stage I non-small cell lung cancer (NSCLC) but not all patients are cured, as demonstrated by a 5-year survival rate of less than 60% in these patients. There is a clear need for a diagnostic test to identify which patients should receive post-surgical therapy, such as chemotherapy, and which patients don't need further treatment, thus avoiding unnecessary treatment related toxicity and complications. Fluorodeoxyglucose (FDG) is radiolabeled analogue of glucose whose concentration within a tumor can be measured with a positron emission tomography (PET) imaging scanner.

Researchers from Duke University Medical Center reviewed 336 patients diagnosed between 2005 and 2010 with stage I NSCLC who underwent FDG/PET within 90 days of surgery to determine if FDG uptake, as measured by maximum standard uptake value (SUVmax) with PET, was associated with overall survival or time to recurrence. The median follow-up was 5.1 years.

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