Valor pronóstico del SUVmáx del tumor primario pretratamiento con PET/TC con 18F-FDG en pacientes con cáncer de pulmón no microcítico en estadio II / Prognostic value of primary tumor SUVmax on pre-treatment 18F-FDG PET/CT imaging in patients with stage iii non-small cell lung cancer

Objetivos: La quimiorradioterapia concomitante (QRTC) se utiliza de forma amplia para tratar a los pacientes con cáncer de pulmón no microcítico (CPNM) en estadio iii. La identificación precoz de los pacientes con mal pronóstico constituye la premisa del tratamiento personalizado de los pacientes. El objetivo de este estudio fue evaluar el valor pronóstico de los parámetros clínicos y SUVmáx del tumor primario sobre PET/TC con 18F-FDG pretratamiento en los pacientes con CPNM en estadio iii. Material y métodos: Se revisaron retrospectivamente las historias clínicas de 79 pacientes de CPNM en estadio iii con PET/TC con 18F-FDG pretratamiento, tratados con QRTC definitiva. Se correlacionaron los criterios de evaluación clínicos en términos de supervivencia libre de progresión (SLP) y supervivencia global (SG) con el valor SUVmáx medio del tumor primario pretratamiento. También se analizaron otros factores de influencia en el resultado del paciente. Resultados: La edad media de los pacientes fue de 58 años (rango, 45-71), con 72 (91%) varones. El carcinoma de células escamosas (73%) fue el tipo histológico más común. El estatus del desempeño fue muy bueno (ECOG 0) en el 64,5% de los pacientes. Sesenta (79%) pacientes habían fallecido en el momento de este análisis. Los valores medios de SG y SLP fueron de 22,5 y 12 meses, respectivamente. Los pacientes se dicotomizaron con arreglo a SUVmáx del tumor primario pretratamiento≤15 vs.>15. No se encontró ninguna diferencia significativa para SG y SLP entre ambas ramas. El análisis multivariante reflejó que el SUVmáx pretratamiento no constituía un factor predictivo de SG (HR 1,099, p=0,726) ni SLP (HR 1,022, p=0,941). Conclusiones: El índice SUVmáx con un valor límite de 15 con respecto al tumor primario pretratamiento no tiene valor pronóstico en nuestro grupo de pacientes de CPNM en estadio iii, tratados con QRTC definitiva

Objectives: Concomitant chemoradiotherapy (CCRT) is widely used in the treatment of patients with stage iii non-small cell lung carcinoma (NSCLC). The early identification of patients with poor prognosis is the premise of personalized treatment for patients. The aim of the study was to evaluate the prognostic value of clinical parameters and primary tumor SUVmax on pre-treatment 18F-FDG PET/CT in patients with stage iii NSCLC. Material and methods: Clinical records of 79 stage iii-NSCLC patients with pre-treatment 18F-FDG PET/CT imaging, treated with definitive CCRT were retrospectively reviewed. The clinical endpoints in terms of progression-free survival (PFS) and overall survival (OS) were correlated with the median pre-treatment primary tumor SUVmax. Furthermore, other factors influencing patient outcome were analyzed. Results: The median age of patients was 58 years (range, 45-71) with 72 (91%) males. Squamous cell carcinoma (73%) was the most common histologic type. Performance status was very good (ECOG 0) in 64.5% of patients. Sixty (79%) patients had died at the time of this analysis. Median OS and PFS were 22.5 and 12.0 months, respectively. Patients were dichotomized according to pre-treatment primary tumor SUVmax≤15.0 vs.>15.0. There was no statistically significant difference for OS and PFS in both arms. Multivariate analysis showed that pre-treatment SUVmax was not a significant predictor of OS (HR 1.099, P=0.726) and PFS (HR 1.022, P=0.941). Conclusions: SUVmax with threshold value of 15.0 on the primary tumor before treatment had no prognostic value in our patient group with stage iii NSCLC treated with definitive CCRT

Prognostic value of primary tumor SUVmax on pre-treatment 18F-FDG PET/CT imaging in patients with stage iii non-small cell lung cancer. / Valor pronóstico del SUVmáx del tumor primario pretratamiento con PET/TC con 18F-FDG en pacientes con cáncer de pulmón no microcítico en estadio iii.

OBJECTIVES: Concomitant chemoradiotherapy (CCRT) is widely used in the treatment of patients with stage iii non-small cell lung carcinoma (NSCLC). The early identification of patients with poor prognosis is the premise of personalized treatment for patients. The aim of the study was to evaluate the prognostic value of clinical parameters and primary tumor SUVmax on pre-treatment 18F-FDG PET/CT in patients with stage iii NSCLC. MATERIAL AND METHODS: Clinical records of 79 stage iii-NSCLC patients with pre-treatment 18F-FDG PET/CT imaging, treated with definitive CCRT were retrospectively reviewed. The clinical endpoints in terms of progression-free survival (PFS) and overall survival (OS) were correlated with the median pre-treatment primary tumor SUVmax. Furthermore, other factors influencing patient outcome were analyzed. RESULTS: The median age of patients was 58 years (range, 45-71) with 72 (91%) males. Squamous cell carcinoma (73%) was the most common histologic type. Performance status was very good (ECOG 0) in 64.5% of patients. Sixty (79%) patients had died at the time of this analysis. Median OS and PFS were 22.5 and 12.0 months, respectively. Patients were dichotomized according to pre-treatment primary tumor SUVmax≤15.0 vs.>15.0. There was no statistically significant difference for OS and PFS in both arms. Multivariate analysis showed that pre-treatment SUVmax was not a significant predictor of OS (HR 1.099, P=0.726) and PFS (HR 1.022, P=0.941). CONCLUSIONS: SUVmax with threshold value of 15.0 on the primary tumor before treatment had no prognostic value in our patient group with stage iii NSCLC treated with definitive CCRT.

Are serum leptin levels a prognostic factor in advanced lung cancer?

AIM: The aim of the present study was to evaluate pre-treatment concentrations of leptin in patients with advanced lung cancer and to investigate possible associations between their levels and clinicopathological variables, response to therapy and overall survival. MATERIAL AND METHODS: There are 71 previously untreated patients with cytological or histological evidence of primary lung cancer who were admitted to the oncology department between November 2013 and August 2014. Forty-five healthy individuals with age, sex and BMI matching the lung cancer patients, were recruited to take part in the study as a control group. Leptin levels were measured quantitatively by using a microELISA kit. RESULTS: The serum leptin levels at diagnosis were significantly lower in lung cancer patients than those in control subjects (4.75±4.91 ng/ml, 9.67±8.02 ng/ml; p<0.001). We did not find any significant difference in leptin values related to clinicopathological parameters such as ECOG PS, weight loss, histological type, disease stage and TNM classification. Nevertheless, we demonstrated a significant correlation between serum leptin levels and BMI in lung cancer patients (correlation coefficient: 0.303; p>0.010). The analysis of serum leptin values did not show any association with the overall survival of the patients. CONCLUSION: Our results showed that the serum leptin level has no prognostic indications in advanced lung cancer patients. Leptin is decreased in lung cancer, and there is lack of correlation with tumour­related factors including prognosis. Therefore, leptin is not a useful clinical marker in lung cancer (Tab. 2, Fig. 2, Ref. 22).