Novel noninvasive measurement of total @entity5 glycolysis by PET predicts survival after complete surgical resection of XXXX .

@entity1 @entity5 @entity1149 @entity2802 @entity204
UNASSIGNED: 7049 Background: Current clinical staging of @entity1 with newly diagnosed @entity1149 ( @entity1149 ) does not specifically predict prognosis or identify @entity1 most likely to benefit from combined modality therapy. Previously, we showed that pathologic @entity5 size and SUVmax on FDG PET scan more accurately predicted prognosis after resection of @entity1149 than other clinical variables. To extend this work, we developed a novel FDG PET parameter, the total lesion glycolysis (TLG), which integrates noninvasively measured @entity5 volume and glycolytic activity (unit measurement = gms), and tested this as a prognostic indicator. METHODS: Retrospective database review revealed 95 previously untreated consecutive @entity1 who underwent a R0 resection of @entity1149 and also had a preoperative FDG PET scan. Parameters evaluated were: resected @entity5 size, @entity2802 status, histology, SUVmax, and TLG. Survival was analyzed by Kaplan Meier, prognostic factors by log rank. p was significant if <.05. RESULTS: Of 95 @entity1 studied, 29 died during the followup period. The median follow-up of surviving @entity1 was 21 months. TLG had a high rank correlation with the resected @entity5 volume (74%, p<0.001). By univariate analysis, SUVmax, TLG, nodal status, histology, @entity2802 status, and pathologic @entity5 diameter all predicted overall survival. However, by multivariable analysis, TLG was the only statistically significant independent predictor of overall survival. Each 10-fold increase in TLG almost doubled the risk of @entity204 , hazard ratio=1.9 (p<0.001). At 3 years, 80% of @entity1 with a TLG<125 gms were alive compared to 53% of those with TLG>125 gms (p<0.001). CONCLUSIONS: TLG is measurable preoperatively from PET images and is a novel non-invasive predictor of survival after @entity1149 resection. TLG can help select poor prognosis @entity5 for induction therapy. No significant financial relationships to disclose.
