TY - JOUR
T1 - Extra-thoracic tumor burden but not thoracic tumor burden on 18F-FDG PET/CT is an independent prognostic biomarker for extensive-disease small cell lung cancer
AU - Oh, Jong Ryool
AU - Seo, Ji Hyoung
AU - Hong, Chae Moon
AU - Jeong, Shin Young
AU - Lee, Sang Woo
AU - Lee, Jaetae
AU - Min, Jung Joon
AU - Song, Ho Chun
AU - Bom, Hee Seung
AU - Kim, Young Chul
AU - Ahn, Byeong Cheol
PY - 2013/8
Y1 - 2013/8
N2 - Purpose: The aim of this study was to evaluate the relationship and difference in prognostic significance between whole-body tumor burden, thoracic tumor burden, and extra-thoracic tumor burden on 18F-FDG PET/CT for patients with extensive-disease small cell lung cancer (ED-SCLC). Materials and methods: We performed a retrospective, two-center analysis for patients with ED-SCLC who underwent pretreatment 18F-FDG PET/CT. Metabolic tumor burden was estimated using whole-body metabolic tumor volume (MTVWB), thoracic metabolic tumor volume (MTVTRX), extra-thoracic metabolic tumor volume (MTVEXT), and the number of extra-thoracic tumor foci. Uni- and multivariate analyses were performed using various clinical factors and the metabolic indices. Results: A total of 91 patients were eligible for this study. MTVWB showed stronger correlation with MTVEXT than MTVTRX (r2=0.804 vs. 0.132, p<0.001, both), whereas no correlation was observed between MTVEXT and MTVTRX (r2=0.007, p=0.428). Patients with smaller MTVWB, MTVEXT, and extra-thoracic tumor foci showed longer survival than patients with larger MTVWB, MTVEXT, and extra-thoracic tumor foci, respectively, whereas the survival difference between patients with smaller MTVTRX and those with larger MTVTRX was not significant. Results of uni- and multivariate analyses showed that ECOG performance status (HR=2.31, p=0.015), initial chemotherapy cycles (HR=0.24, p<0.001), and the number of extra-thoracic tumor foci (HR=2.75, p<0.001) were independent prognostic factors for overall survival, and initial chemotherapy cycles (HR=0.25, p<0.001), and MTVEXT (HR=2.04, p=0.013) were independent prognostic factors for progression-free survival. Conclusion: These data provide evidence indicating that extra-thoracic tumor burden but not thoracic tumor burden is an independent prognostic biomarker for ED-SCLC, and support further exploration of novel treatment strategies targeting extra-thoracic tumor burden in order to improve the clinical outcomes of patients with ED-SCLC.
AB - Purpose: The aim of this study was to evaluate the relationship and difference in prognostic significance between whole-body tumor burden, thoracic tumor burden, and extra-thoracic tumor burden on 18F-FDG PET/CT for patients with extensive-disease small cell lung cancer (ED-SCLC). Materials and methods: We performed a retrospective, two-center analysis for patients with ED-SCLC who underwent pretreatment 18F-FDG PET/CT. Metabolic tumor burden was estimated using whole-body metabolic tumor volume (MTVWB), thoracic metabolic tumor volume (MTVTRX), extra-thoracic metabolic tumor volume (MTVEXT), and the number of extra-thoracic tumor foci. Uni- and multivariate analyses were performed using various clinical factors and the metabolic indices. Results: A total of 91 patients were eligible for this study. MTVWB showed stronger correlation with MTVEXT than MTVTRX (r2=0.804 vs. 0.132, p<0.001, both), whereas no correlation was observed between MTVEXT and MTVTRX (r2=0.007, p=0.428). Patients with smaller MTVWB, MTVEXT, and extra-thoracic tumor foci showed longer survival than patients with larger MTVWB, MTVEXT, and extra-thoracic tumor foci, respectively, whereas the survival difference between patients with smaller MTVTRX and those with larger MTVTRX was not significant. Results of uni- and multivariate analyses showed that ECOG performance status (HR=2.31, p=0.015), initial chemotherapy cycles (HR=0.24, p<0.001), and the number of extra-thoracic tumor foci (HR=2.75, p<0.001) were independent prognostic factors for overall survival, and initial chemotherapy cycles (HR=0.25, p<0.001), and MTVEXT (HR=2.04, p=0.013) were independent prognostic factors for progression-free survival. Conclusion: These data provide evidence indicating that extra-thoracic tumor burden but not thoracic tumor burden is an independent prognostic biomarker for ED-SCLC, and support further exploration of novel treatment strategies targeting extra-thoracic tumor burden in order to improve the clinical outcomes of patients with ED-SCLC.
KW - F-FDG PET/CT
KW - Biomarker
KW - Extensive disease small cell lung cancer
KW - Metabolic tumor volume
KW - Oligometastases
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=84879883668&partnerID=8YFLogxK
U2 - 10.1016/j.lungcan.2013.05.001
DO - 10.1016/j.lungcan.2013.05.001
M3 - Article
C2 - 23731740
AN - SCOPUS:84879883668
SN - 0169-5002
VL - 81
SP - 218
EP - 225
JO - Lung Cancer
JF - Lung Cancer
IS - 2
ER -