Application of 18F-FDG PET/CT to adjuvant chemotherapy forearly stage(IB-IIA) lung adenocarcinoma

1276 Purpose: This study aimed to determine the significance of the preoperative maximum standardized uptake value (SUVmax) on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) images on postoperative adjuvant chemotherapy for lung adenocarcinoma. Methods: We assessed tumor-free survival (TFS) and overall survival (OS) based on SUVmax values derived from preoperative FDG-PET/CT images in 127 consecutive patients with completely resected pathologic stage IB-IIA (T2a-T2bN0M0) lung adenocarcinoma. According to preoperative SUVmax and clinical prognostic factors, including age, gender, tumor size, poor tumor differentiation, vascular invasion, wedge resection, visceral pleural invasion, insufficient lymph node dissection, and adjuvant chemotherapy, Kaplan-Meier method was used to draw survival curves and log-rank was used to test the survival differences among groups. Cox proportional hazards model was then performed. The difference was statistically significant at Pl0.05. Results: 57 patients received adjuvant chemotherapy and 70 did not. Adjuvant chemotherapy conferred benefits on TFS and OS when compared with observation (pl0.002and pl0.004, respectively). Multivariate Cox regression analyses revealed preoperative SUVmax as an independent prognostic factor for TFS and OS. TFS and OS were significantly longer for patients who received adjuvant chemotherapy compared with those who did not in the group with SUVmax greater than or equal to 2.95 (pl0.001 and p l0.003, respectively). However, TFS and OS did not differ significantly between such patients in the group with SUVmax less than 2.95 (pl0.41 and pl0.54, respectively). Conclusions: Preoperative SUVmax determined from FDG-PET/CT images reflected the effect of adjuvant chemotherapy after complete resection in patients with pathologic stage T2abN0M0 lung adenocarcinoma. Indications for postoperative adjuvant chemotherapy among patients with lung adenocarcinoma might be more precisely determined using preoperative SUVmax derived from FDG PET/CT images together. Key words: lung adenocarcinoma, PET/CT, maximum standardized uptake value, post-adjuvant chemotherapy, tumor-free survival, overall survival