Prognostic impact of maximum standardized uptake value (SUVmax) of the primary lesion on survival in advanced non-small-cell lung cancer: A retrospective study

Background: Positron emission tomography/computed tomography (PET/CT) has been widely recognized for diagnosing and staging lung cancer, but the prognostic value of standardized uptake value (SUV) in patients with advanced non-small-cell lung cancer (NSCLC) remains controversial. We aim to explore whether fluorodeoxyglucose uptake has prognostic significance in patients with advanced NSCLC. Methods: We performed a retrospective analysis of the data of patients with advanced NSCLC who had undergone PET/CT before systemic treatment between June 2012 and June 2016. The relationship between the SUV of the pulmonary lesion and lesion size was evaluated via Spearman’s correlation analysis. We collected patients’ clinical and pathological data. Univariate and multivariate analyses were performed to analyze the factors influencing survival.Results: Altogether, 157 patients with advanced NSCLC were included. Among these, 135 died, 13 survived, and 9 had incomplete data (median follow-up period of 69 months). SUV was correlated with lesion size and was significantly greater for tumors ≥3 cm than for tumors <3 cm (10.2±5.4 vs. 5.6±3.3, t=-6.709, p=0.000). Univariate analysis showed that survival was associated with gender, tumor size, epidermal growth factor receptor (EGFR) gene mutation, SUV of the primary lung lesion, and treatment line. Multivariate analysis showed a significant correlation between SUV of the primary lung lesion and survival. The mortality risk of patients with SUV ≤6 was 35% lower than that of patients with SUV >6 (95% CI 0.436-0.972, Wald value 4.400, p=0.036). Conclusions: The SUV of the primary lung lesion on PET/CT is significantly correlated with survival in previously untreated patients newly diagnosed with advanced NSCLC.