PT  - JOURNAL ARTICLE
AU  - Emma Denneny
AU  - Sarah Clarke
AU  - Ravi Ragatha
AU  - Samir Naik
AU  - Peter Russell
AU  - Nick Panagiotopoulos
AU  - David Lawrence
AU  - Ugo Ekeowa
TI  - Should preoperative FDG uptake on PET/CT guide postoperative surveillance in surgical non-small cell lung cancer (NSCLC)
AID  - 10.1183/13993003.congress-2016.PA4849
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - PA4849
VI  - 48
IP  - suppl 60
4099  - http://erj.ersjournals.com/content/48/suppl_60/PA4849.short
4100  - http://erj.ersjournals.com/content/48/suppl_60/PA4849.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - Introduction There is no consensus regarding modality or timing for postoperative surveillance in patients undergoing surgery with curative intent for early stage NSCLC. Some suggest that preoperative PET/CT Standard Uptake Variable (SUV) scores may identify patients at higher risk of poor outcomes1. We aimed to assess if preoperative FDG uptake highlights subgroups likely to benefit from more intensive postsurgical surveillance.Methods We retrospectively reviewed 82 patients with stage 1-2 NSCLC undergoing surgery with curative intent between 2011 and 2015. Analysis was performed in quartiles defined by preoperative PET SUVmax scores.Results Median time to first postoperative imaging was 3 months, with CT the chosen modality in 56%. Adenocarcinoma accounted for 62% of surgical resections and 69% of recurrences. 57% of patients with recurrent disease had undergone lobectomy. Overall recurrence rate was 17% (64% pulmonary) with mortality of 71%. The highest quartile group (SUVmax 13-26) showed a recurrence rate of 25% with a median time to recurrence of 9 months (interquartile range 4-12). The second group showed an identical median time to recurrence of 9 months (IQR 6-22), the third group 18 months (IQR 8–30) and the lowest quartile group (SUVmax 0-2.4) had one recurrence at 13 months.Conclusion Our results suggest that preoperative FDG uptake may have a role in identifying patients who require more intensive postoperative cancer recurrence surveillance with CT in the first year. It remains to be established if this would be associated with a survival benefit.1Liu J, Dong M, Sun X, Li W, Xing L, Yu J. PLoS One. 2016; 11(1): e0146195.