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Distinct prognostic impact of PET findings based on radiological appearance in clinical stage IA lung adenocarcinoma

Published:November 18, 2022DOI:https://doi.org/10.1016/j.cllc.2022.10.007

      Abstract

      Introduction

      Although solid appearance on computed tomography (CT) and positive findings on positron emission tomography (PET) have been both associated with poor outcome in lung adenocarcinoma, the extent to which these findings overlap is unknown. This study aimed to determine the differences in prognostic significance of PET findings in part-solid nodules (PSNs) and solid nodules.

      Materials and Methods

      We retrospectively investigated 417 patients with clinical stage IA adenocarcinoma who underwent curative resection between 2010 and 2017. We compared disease-free survival (DFS), cumulative incidence of disease recurrence (CIR) and clinicopathological characters between PET-positive and negative groups among PSNs and solid nodules, respectively. We used 2.5 as a cut-off value of maximum standardized uptake value (SUV max).

      Results

      In PSNs (n=235), PET-positive group (n=59) showed more aggressive features in several clinicopathological variables, poorer DFS (p < 0.001) and higher CIR (p < 0.001) than PET-negative group (n=176). In contrast, in solid nodules (n=182), DFS (p = 0.521) and CIR (p= 0.311) were not significantly different between PET-positive (n=128) and negative groups (n=54). SUV max was proved to be the independent prognostic factor of DFS by multivariate analysis (HR, 1.155; 95% CI, 1.036–1.287) only in PSNs.

      Conclusion

      These findings showed distinct impact on prognosis of PET findings between PSNs and solid nodules. PET-positive finding was more important prognostic factor in PSNs than in solid nodules among clinical stage IA lung adenocarcinoma.

      MicroAbstract

      We investigated the prognostic significance of PET findings based on the radiological appearance of stage IA lung adenocarcinoma. More aggressive clinicopathological features and significantly worse outcomes were features of PET-positive part-solid nodules (PSNs) in comparison to PET-negative PSNs, but not in solid nodules. Thus, the prognostic impact of PET findings differs between part-solid and solid nodules.

      Keywords

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