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Follow-up or Surveillance (18)F-FDG PET/CT and Survival Outcome in Lung Cancer Patients.

Publication ,  Journal Article
Antoniou, AJ; Marcus, C; Tahari, AK; Wahl, RL; Subramaniam, RM
Published in: J Nucl Med
July 2014

UNLABELLED: The value of performing follow-up PET/CT imaging more than 6 mo after the conclusion of therapy-either as a routine practice or because of clinically suspected recurrence-is not well established. The purpose of this study was to evaluate the added value of follow-up PET/CT to the clinical assessment and survival outcome of lung cancer patients. METHODS: This was a retrospective study of 261 biopsy-proven lung cancer patients at a single tertiary center. In total, 488 follow-up PET/CT scans done 6 or more months after the completion of initial treatment were included in this study. Median follow-up from the completion of primary treatment was 29.3 mo (range, 6.1-295.1 mo). Overall survival (OS) benefit was measured using Kaplan-Meier plots with a Mantel-Cox log-rank test. A multivariate Cox regression model was provided with clinical covariates. RESULTS: Of the 488 PET/CT scans, 281 were positive and 207 negative for recurrence. Overall median survival from the time of the PET/CT study was 48.5 mo. The median survival of PET-positive and PET-negative groups was 32.9 and 81.6 mo, respectively (P < 0.0001). A subgroup analysis demonstrated a similar difference in OS for 212 scans completed between 6 and 24 mo after treatment (P = 0.0004) and 276 scans completed after 24 mo (P = 0.0006). In the context of clinical assessment, PET/CT identified recurrence in 43.7% (107/245) of scans without prior clinical suspicion and ruled out recurrence in 15.2% (37/243) of scans with prior clinical suspicion. There was a significant difference in OS when grouped by clinical suspicion (P = 0.0112) or routine follow-up (P < 0.0001). In a multivariate Cox regression model, factors associated with OS were age (P < 0.0001) and PET/CT result (P = 0.0003). An age-stratified subgroup analysis demonstrated a significant difference in OS by PET scan result among patients younger than 60 y and between 60 and 70 y but not in those older than 70 y (P < 0.0001, P = 0.0004, and P = 0.8193, respectively). CONCLUSION: (18)F-FDG PET/CT performed for follow-up more than 6 mo after the completion of primary treatment adds value to clinical judgment and is a prognostic marker of OS in lung cancer patients, regardless of the timing of the follow-up scan, and especially in patients younger than 70 y.

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Published In

J Nucl Med

DOI

EISSN

1535-5667

Publication Date

July 2014

Volume

55

Issue

7

Start / End Page

1062 / 1068

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Positron-Emission Tomography
  • Nuclear Medicine & Medical Imaging
  • Multimodal Imaging
  • Middle Aged
  • Male
  • Lung Neoplasms
 

Citation

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MLA
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Antoniou, A. J., Marcus, C., Tahari, A. K., Wahl, R. L., & Subramaniam, R. M. (2014). Follow-up or Surveillance (18)F-FDG PET/CT and Survival Outcome in Lung Cancer Patients. J Nucl Med, 55(7), 1062–1068. https://doi.org/10.2967/jnumed.113.136770
Antoniou, Alexander J., Charles Marcus, Abdel K. Tahari, Richard L. Wahl, and Rathan M. Subramaniam. “Follow-up or Surveillance (18)F-FDG PET/CT and Survival Outcome in Lung Cancer Patients.J Nucl Med 55, no. 7 (July 2014): 1062–68. https://doi.org/10.2967/jnumed.113.136770.
Antoniou AJ, Marcus C, Tahari AK, Wahl RL, Subramaniam RM. Follow-up or Surveillance (18)F-FDG PET/CT and Survival Outcome in Lung Cancer Patients. J Nucl Med. 2014 Jul;55(7):1062–8.
Antoniou, Alexander J., et al. “Follow-up or Surveillance (18)F-FDG PET/CT and Survival Outcome in Lung Cancer Patients.J Nucl Med, vol. 55, no. 7, July 2014, pp. 1062–68. Pubmed, doi:10.2967/jnumed.113.136770.
Antoniou AJ, Marcus C, Tahari AK, Wahl RL, Subramaniam RM. Follow-up or Surveillance (18)F-FDG PET/CT and Survival Outcome in Lung Cancer Patients. J Nucl Med. 2014 Jul;55(7):1062–1068.

Published In

J Nucl Med

DOI

EISSN

1535-5667

Publication Date

July 2014

Volume

55

Issue

7

Start / End Page

1062 / 1068

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Retrospective Studies
  • Proportional Hazards Models
  • Prognosis
  • Positron-Emission Tomography
  • Nuclear Medicine & Medical Imaging
  • Multimodal Imaging
  • Middle Aged
  • Male
  • Lung Neoplasms