Abstract
Background
Number of metastatic sites can identify patient populations with non–small cell lung
cancer (NSCLC) that benefit from aggressive therapy. Total volume of disease is also
relevant. We evaluated the prognostic impact of biologically active volume of disease
(BaVD) on patients with metastatic lung adenocarcinoma.
Materials and Methods
Positron emission tomography/computerized tomography (PET/CT) scans from patients
with newly diagnosed lung adenocarcinoma prior to starting any therapy were identified.
SUV thresholds of 3 and 4 were used to auto-contour all FDG avid areas. Kaplan-Meier
analysis and Cox regression were performed to examine influence on OS.
Results
One hundred forty-eight patients were included in the analysis. The median BaVD when
using an SUV threshold of 3 was 122.8 mL. The median BaVD when using an SUV threshold
of 4 was 46.2 mL When stratified by median BaVD using an SUV of 3, median OS was higher
for patients with <=122.8 mL (2.12 years) compared to patients with >122.8 mL (1.46
years) (log-rank P = .001). Similarly, when stratified by median BaVD using an SUV of 4, median OS was
higher for patients with <=46.2 mL (1.91 years; 95% CI: 1.65-3.22 years) compared
to patients with >46.2 mL (1.48 years; 95% CI: 1.07-1.80 years) (log-rank P = .007). On multivariable analysis, BaVD was significantly associated with OS when
using an SUV threshold of 3 (HR: 20.169, P < .001) and 4 (HR: 4.117, P < .001).
Conclusion
BaVD is an important prognostic factor in metastatic lung adenocarcinoma and may aid
identification of patients with limited disease who may be candidates for more aggressive
therapies.
Keywords
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Article info
Publication history
Published online: January 20, 2023
Accepted:
January 12,
2023
Received in revised form:
January 11,
2023
Received:
November 22,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
