Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
International Journal of Clinical Oncology
Published in: International Journal of Clinical Oncology 6/2020

01-06-2020 | Computed Tomography | Original Article

Use of a prognostic risk score that aggregates the FDG-PET/CT SUVmax, tumor size, and histologic group for predicting the prognosis of pStage I lung adenocarcinoma

Authors: Naoya Kawakita, Hiroaki Toba, Yukikiyo Kawakami, Hiromitsu Takizawa, Yoshimi Bando, Hideki Otuska, Daisuke Matsumoto, Mika Takashima, Mitsuhiro Tsuboi, Mitsuteru Yoshida, Kazuya Kondo, Akira Tangoku

Published in: International Journal of Clinical Oncology | Issue 6/2020

Login to get access

Abstract

Background

pStage I includes clinicopathologically diverse groups. This study aimed to identify the prognostic factors for pStage I lung adenocarcinoma.

Methods

We retrospectively reviewed 208 patients with pStage I adenocarcinomas who underwent curative resection in our institute between 2006 and 2013. The maximum standardized uptake value (SUVmax) on [F18]-fluoro-deoxy-d-glucose positron emission tomography-computed tomography (PET/CT) was evaluated. Adenocarcinomas were categorized into the following histologic groups: group 0 (minimally invasive adenocarcinoma and lepidic predominant adenocarcinoma), group 1 (papillary predominant adenocarcinoma), and group 2 (acinar predominant adenocarcinoma and all the remaining subtypes). We assessed the relationship between disease-free survival (DFS) and clinicopathological factors.

Results

Multivariate analysis of DFS demonstrated that SUVmax > 3.0 (p < 0.001), total tumor size > 20 mm (p = 0.016), and histologic groups (p < 0.05) were independent prognostic factors. The prognostic risk score (PRS) was calculated using the following equation: PRS = SUVmax (≤ 3.0: 0 point, > 3.0: 2 points) + total tumor size (≤ 20 mm: 0 point, > 20 mm: 1 point) + histologic group (group 0: 0 point, group 1: 1 point, group 2: 2 points). Patients were divided into the following three risk groups: low-risk (PRS 0–2 points, n = 136), intermediate-risk (PRS 3–4 points, n = 49), and high-risk groups (PRS 5 points, n = 13). The 5-year DFS rates were 93.2%, 50.6%, and 30.8% for the low-, intermediate-, and high-risk groups, respectively (p < 0.001).

Conclusions

The PRS aggregating the FDG-PET/CT SUVmax, total tumor size, and histologic group predicts the prognosis of pStage I lung adenocarcinoma.
Appendix
Available only for authorised users
Literature
1.
Fu C, Liu Z, Zhu F et al (2016) A meta-analysis: is low-dose computed tomography a superior method for risky lung cancers screening population? Clin Respir J 10:333–341CrossRefPubMed
2.
Sawabata N, Miyaoka E, Asamura H et al (2011) Japanese lung cancer registry study of 11,663 surgical cases in 2004: demographic and prognosis changes over decade. J Thorac Oncol 6:1229–1235CrossRefPubMed
3.
Masuda M, Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery et al (2016) Thoracic and cardiovascular surgery in Japan during 2014: annual report by the Japanese association for thoracic surgery. Gen Thorac Cardiovasc Surg 64:665–697CrossRefPubMedPubMedCentral
4.
Goldstraw P, Crowley J, Chansky K et al (2007) The IASLC lung cancer staging project: proposals for the revision of the TNM stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol 2:706–714CrossRefPubMed
5.
Yoshizawa A, Sumiyoshi S, Sonobe M et al (2013) Validation of the IASLC/ATS/ERS lung adenocarcinoma classification for prognosis and association with EGFR and KRAS gene mutations: analysis of 440 Japanese patients. J Thorac Oncol 8:52–61CrossRefPubMed
6.
Yang HC, Kim HR, Jheon S et al (2015) Recurrence risk-scoring model for stage I adenocarcinoma of the lung. Ann Surg Oncol 22:4089–4097CrossRefPubMed
7.
Uehara H, Tsutani Y, Okumura S et al (2013) Prognostic role of positron emission tomography and high-resolution computed tomography in clinical stage IA lung adenocarcinoma. Ann Thorac Surg 96:1958–1965CrossRefPubMed
8.
Kadota K, Colovos C, Suzuki K et al (2012) FDG-PET SUVmax combined with IASLC/ATS/ERS histologic classification improves the prognostic stratification of patients with stage I lung adenocarcinoma. Ann Surg Oncol 19:3598–3605CrossRefPubMedPubMedCentral
9.
Nair VS, Krupitskaya Y, Gould MK (2009) Positron emission tomography 18F-fluorodeoxyglucose uptake and prognosis in patients with surgically treated, stage I non-small cell lung cancer: a systematic review. J Thorac Oncol 4:1473–1479CrossRefPubMed
10.
Sun Y, Hou L, Yang Y et al (2016) Two-gene signature improves the discriminatory power of IASLC/ATS/ERS classification to predict the survival of patients with early-stage lung adenocarcinoma. Oncol Targets Ther 9:4583–4591CrossRef
11.
Yoshizawa A, Motoi N, Riely GJ et al (2011) Impact of proposed IASLC/ATS/ERS classification of lung adenocarcinoma: prognostic subgroups and implications for further revision of staging based on analysis of 514 stage I cases. Mod Pathol 24:653–664CrossRefPubMed
12.
Takahashi Y, Horio H, Hato T et al (2015) Prognostic significance of preoperative neutrophil-lymphocyte ratios in patients with stage I non-small cell lung cancer after complete resection. Ann Surg Oncol 22(Suppl 3):S1324–1331CrossRefPubMed
13.
Yoshino I, Kawano D, Oba T et al (2006) Smoking status as a prognostic factor in patients with stage I pulmonary adenocarcinoma. Ann Thorac Surg 81:1189–1193CrossRefPubMed
14.
Hamada C, Tanaka F, Ohta M et al (2005) Meta-analysis of postoperative adjuvant chemotherapy with tegafur-uracil in non-small-cell lung cancer. J Clin Oncol 23:4999–5006CrossRefPubMed
15.
Kato H, Ichinose Y, Ohta M et al (2004) A randomized trial of adjuvant chemotherapy with uracil-tegafur for adenocarcinoma of the lung. N Engl J Med 350:1713–1721CrossRefPubMed
16.
Toba H, Kondo K, Sadohara Y et al (2013) 18F-fluorodeoxyglucose positron emission tomography/computed tomography and the relationship between fluorodeoxyglucose uptake and the expression of hypoxia-inducible factor-1alpha, glucose transporter-1 and vascular endothelial growth factor in thymic epithelial tumours. Eur J Cardiothorac Surg 44:e105–112CrossRefPubMed
17.
Travis WD, Brambilla E, Noguchi M et al (2011) International association for the study of lung cancer/American thoracic society/European respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol 6:244–285CrossRefPubMedPubMedCentral
18.
Nakamura H, Saji H, Shinmyo T et al (2015) Close association of IASLC/ATS/ERS lung adenocarcinoma subtypes with glucose-uptake in positron emission tomography. Lung Cancer 87:28–33CrossRefPubMed
19.
Russell PA, Wainer Z, Wright GM et al (2011) Does lung adenocarcinoma subtype predict patient survival?: a clinicopathologic study based on the new international association for the study of lung cancer/American thoracic society/European respiratory society international multidisciplinary lung adenocarcinoma classification. J Thorac Oncol 6:1496–1504CrossRefPubMed
20.
Watanabe K, Nomori H, Ohtsuka T et al (2006) [f-18]fluorodeoxyglucose positron emission tomography can predict pathological tumor stage and proliferative activity determined by Ki-67 in clinical stage IA lung adenocarcinomas. Jpn J Clin Oncol 36:403–409CrossRefPubMed
21.
Paesmans M, Berghmans T, Dusart M et al (2010) Primary tumor standardized uptake value measured on fluorodeoxyglucose positron emission tomography is of prognostic value for survival in non-small cell lung cancer: Update of a systematic review and meta-analysis by the European lung cancer working party for the international association for the study of lung cancer staging project. J Thorac Oncol 5:612–619CrossRefPubMed
22.
Gu J, Lu C, Guo J et al (2013) Prognostic significance of the IASLC/ATS/ERS classification in Chinese patients-a single institution retrospective study of 292 lung adenocarcinoma. J Surg Oncol 107:474–480CrossRefPubMed
23.
Warth A, Muley T, Meister M et al (2012) The novel histologic international association for the study of lung cancer/American thoracic society/European respiratory society classification system of lung adenocarcinoma is a stage-independent predictor of survival. J Clin Oncol 30:1438–1446CrossRefPubMed
24.
Tsuta K, Kawago M, Inoue E et al (2013) The utility of the proposed IASLC/ATS/ERS lung adenocarcinoma subtypes for disease prognosis and correlation of driver gene alterations. Lung Cancer 81:371–376CrossRefPubMed
25.
Kadota K, Yeh YC, Sima CS et al (2014) The cribriform pattern identifies a subset of acinar predominant tumors with poor prognosis in patients with stage I lung adenocarcinoma: a conceptual proposal to classify cribriform predominant tumors as a distinct histologic subtype. Mod Pathol 27:690–700CrossRefPubMed
26.
Nakazato Y, Maeshima AM, Ishikawa Y et al (2013) Interobserver agreement in the nuclear grading of primary pulmonary adenocarcinoma. J Thorac Oncol 8:736–743CrossRefPubMed
27.
Takamochi K, Oh S, Matsunaga T et al (2017) Prognostic impacts of EGFR mutation status and subtype in patients with surgically resected lung adenocarcinoma. J Thorac Cardiovasc Surg 154(1768–1774):e1761
28.
Lin CY, Wu YM, Hsieh MH et al (2017) Prognostic implication of EGFR gene mutations and histological classification in patients with resected stage I lung adenocarcinoma. PLoS ONE 12:e0186567CrossRefPubMedPubMedCentral
29.
Hung JJ, Yeh YC, Jeng WJ et al (2014) Predictive value of the international association for the study of lung cancer/American thoracic society/European respiratory society classification of lung adenocarcinoma in tumor recurrence and patient survival. J Clin Oncol 32:2357–2364CrossRefPubMed
30.
Yanagawa N, Shiono S, Abiko M, Ogata SY, Sato T, Tamura G (2014) The correlation of the international association for the study of lung cancer (IASLC)/American thoracic society (ATS)/European respiratory society (ERS) classification with prognosis and EGFR mutation in lung adenocarcinoma. Ann Thorac Surg 98:453–458CrossRefPubMed
31.
Xu CH, Wang W, Wei Y et al (2015) Prognostic value of the new international association for the study of lung cancer/American thoracic society/European respiratory society classification in stage IB lung adenocarcinoma. Eur J Surg Oncol 41:1430–1436CrossRefPubMed
32.
Arriagada R, Auperin A, NSCLC Meta-analyses Collaborative Group et al (2010) Adjuvant chemotherapy, with or without postoperative radiotherapy, in operable non-small-cell lung cancer: Two meta-analyses of individual patient data. Lancet 375:1267–1277CrossRefPubMed
33.
Pignon JP, Tribodet H, Scagliotti GV et al (2008) Lung adjuvant cisplatin evaluation: a pooled analysis by the lace collaborative group. J Clin Oncol 26:3552–3559CrossRefPubMed
34.
Douillard JY, Rosell R, De Lena M et al (2006) Adjuvant vinorelbine plus cisplatin versus observation in patients with completely resected stage IB-IIIA non-small-cell lung cancer (Adjuvant Navelbine International Trialist Association [ANITA]): a randomised controlled trial. Lancet Oncol 7:719–727CrossRefPubMed
35.
Winton T, Livingston R, Johnson D et al (2005) Vinorelbine plus cisplatin vs. observation in resected non-small-cell lung cancer. N Engl J Med 352:2589–2597CrossRefPubMed
36.
Arriagada R, Bergman B, Dunant A et al (2004) Cisplatin-based adjuvant chemotherapy in patients with completely resected non-small-cell lung cancer. N Engl J Med 350:351–360CrossRefPubMed
37.
Detterbeck FC, Boffa DJ, Kim AW, Tanoue LT (2017) The eighth edition lung cancer stage classification. Chest 151:193–203CrossRefPubMed
Metadata
Title
Use of a prognostic risk score that aggregates the FDG-PET/CT SUVmax, tumor size, and histologic group for predicting the prognosis of pStage I lung adenocarcinoma
Authors
Naoya Kawakita
Hiroaki Toba
Yukikiyo Kawakami
Hiromitsu Takizawa
Yoshimi Bando
Hideki Otuska
Daisuke Matsumoto
Mika Takashima
Mitsuhiro Tsuboi
Mitsuteru Yoshida
Kazuya Kondo
Akira Tangoku
Publication date
01-06-2020
Publisher
Springer Singapore
Published in
International Journal of Clinical Oncology / Issue 6/2020
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI
https://doi.org/10.1007/s10147-020-01637-6

Other articles of this Issue 6/2020

International Journal of Clinical Oncology 6/2020 Go to the issue

Invited Review Article

Diffuse gliomas to date and beyond 2016 WHO Classification of Tumours of the Central Nervous System

Original Article

Prophylactic efficacy of ninjin’yoeito for oxaliplatin-induced cumulative peripheral neuropathy in patients with colorectal cancer receiving postoperative adjuvant chemotherapy: a randomized, open-label, phase 2 trial (HOPE-2)

Original Article

Evaluation of a routine second curettage for hydatidiform mole: a cohort study

Original Article

Down-regulation of miR-200c associates with poor prognosis of oral squamous cell carcinoma

Review Article

Salivary metabolites to detect patients with cancer: a systematic review

Original Article

Comparison of involved field radiotherapy and elective nodal irradiation in combination with concurrent chemotherapy for T1bN0M0 esophageal cancer
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits