Prognostic value of metabolic tumor volume on [18F]FDG PET/CT in addition to the TNM classification system of locally advanced non-small cell lung cancer

2024

Prognostic Value of Metabolic Tumor Volume in Lung Cancer

Sample size: 235 publication 10 minutes Evidence: moderate

Author Information

Author(s): Brose Alexander, Miederer Isabelle, König Jochem, Gkika Eleni, Sahlmann Jörg, Schimek-Jasch Tanja, Schreckenberger Mathias, Nestle Ursula, Kappes Jutta, Miederer Matthias

Primary Institution: Department of Translational Imaging in Oncology, National Center for Tumor Diseases (NCT/UCC) Dresden, Medical Faculty and University Hospital Carl Gustav Carus, TUD Dresden University of Technology

Hypothesis

Can metabolic tumor volume (MTV) improve the prognostic accuracy of the TNM classification system in locally advanced non-small cell lung cancer (NSCLC)?

Conclusion

Higher metabolic tumor volume is significantly associated with worse overall survival and, when combined with TNM staging, provides more precise information about disease prognosis in locally advanced NSCLC treated with chemoradiotherapy.

Supporting Evidence

MTV was associated with significantly worse overall survival independent of stage and other prognostic variables.
Higher MTV was significantly associated with worse survival in locally advanced disease stages treated with chemoradiotherapy.
Using cut-off values for MTV improved survival predictions for stages IIIa-c.
The combination of TNM and MTV staging showed better discrimination for overall survival compared to TNM alone.

Takeaway

This study found that a larger tumor volume measured by PET scans means patients with lung cancer might not live as long, and adding this measurement to standard staging helps doctors predict outcomes better.

Methodology

Retrospective evaluation of 235 patients with histologically proven, locally advanced NSCLC from a clinical cohort and a multi-centre randomized clinical trial, using PET parameters to assess prognostic value.