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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 13/2013

01-12-2013 | Thoracic Oncology

Preoperative Consolidation-to-Tumor Ratio and SUVmax Stratify the Risk of Recurrence in Patients Undergoing Limited Resection for Lung Adenocarcinoma ≤2 cm

Authors: Jun-ichi Nitadori, MD, PhD, Adam J. Bograd, MD, Eduardo A. Morales, MS, Nabil P. Rizk, MD, FACS, Mark P. S. Dunphy, DO, Camelia S. Sima, MD, MS, Valerie W. Rusch, MD, FACS, Prasad S. Adusumilli, MD, FACS, FCCP

Published in: Annals of Surgical Oncology | Issue 13/2013

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Abstract

Purpose

Limited resection is an increasingly utilized option for treatment of clinical stage IA lung adenocarcinoma (ADC) ≤2 cm (T1aN0M0), yet there are no validated predictive factors for postoperative recurrence. We investigated the prognostic value of preoperative consolidation/tumor (C/T) ratio [on computed tomography (CT) scan] and maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose-positron emission tomography (PET) scan.

Methods

We retrospectively reviewed 962 consecutive patients who underwent limited resection for lung cancer at Memorial Sloan-Kettering between 2000 and 2008. Patients with available CT and PET scans were included in the analysis. C/T ratio of 25 % (in accordance with the Japan Clinical Oncology Group 0201) and SUVmax of 2.2 (cohort median) were used as cutoffs. Cumulative incidence of recurrence (CIR) was assessed.

Results

A total of 181 patients met the study inclusion criteria. Patients with a low C/T ratio (n = 15) had a significantly lower 5-year recurrence rate compared with patients with a high C/T ratio (n = 166) (5-year CIR, 0 vs. 33 %; p = 0.015), as did patients with low SUVmax (n = 86) compared with patients with high SUVmax (n = 95; 5-year CIR, 18 vs. 40 %; p = 0.002). Furthermore, within the high C/T ratio group, SUVmax further stratified risk of recurrence [5-year CIR, 22 % (low) vs. 40 % (high); p = 0.018].

Conclusions

With the expected increase in diagnoses of small lung ADC as a result of more widespread use of CT screening, C/T ratio and SUVmax are widely available markers that can be used to stratify the risk of recurrence among cT1aN0M0 patients after limited resection.
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Metadata
Title
Preoperative Consolidation-to-Tumor Ratio and SUVmax Stratify the Risk of Recurrence in Patients Undergoing Limited Resection for Lung Adenocarcinoma ≤2 cm
Authors
Jun-ichi Nitadori, MD, PhD
Adam J. Bograd, MD
Eduardo A. Morales, MS
Nabil P. Rizk, MD, FACS
Mark P. S. Dunphy, DO
Camelia S. Sima, MD, MS
Valerie W. Rusch, MD, FACS
Prasad S. Adusumilli, MD, FACS, FCCP
Publication date
01-12-2013
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 13/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-013-3212-2

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