New imaging markers predict survival of early stage cancer

This study evaluated the role of three markers, measured by positron emission tomography (PET) scans, in predicting survival and recurrence among early stage non-small cell lung cancer (NSCLC) patients.

New methods of predicting survival of early stage patients with NSCLC have been the focus of recent investigation. PET scans are often used to identify specific tumor characteristics (referred to as markers) that may predict disease aggressiveness and help direct treatment and surveillance efforts. New markers now being investigated include standardized uptake value index (SUV index), metabolic tumor volume (MTV) and total lesion glycolysis (TLG). This study investigated the effectiveness of these imaging markers in predicting survival among early stage NSCLC patients.

This study reviewed the medical records of 99 patients, all of whom diagnosed with stage I NSCLC and treated with surgery. PET scan results, including SUV index, MTV and TLG, were available for all patients. SUV index, MTV and TLG were all significantly related to both survival and recurrence.

Among patients with a low SUV index, 84% of patients were alive and disease free 5-years following treatments. This compared to only 59% of patients with a high SUV index. Among patients with low TLG, 88% of patients were alive and disease free 5-years following treatments, compared to only 60% of patients showing high TLG. Among patients with low MTV, 86% of patients were alive and disease free 5-years following treatments, compared to only 62% of patients with high MTV. TLG was found to be the most significant prognostic factor, even after adjusting for multiple parameters (such as tumor size and patient age). Patients with high TLG tumors were almost 5-times more likely to experience cancer recurrence or death, within five years, compared to patients with low TLG tumors.

This study concluded that PET scan derived markers, and specifically TLG, are able to assess the risk of recurrence and mortality among stage I NSCLC patients.