The Utility of SUV_max as an Adaptation Criterion for Limited Resection in Stage IA Non-Small Cell Lung Cancer

Abstract

<b><i>Introduction:</i></b> Although the consolidation diameter of a tumor on computed tomography (CT) is an adaptation criterion for limited resection in early-stage non-small cell lung cancer (NSCLC), whether the maximum standardized uptake value (SUV_max) is also an adaptation criterion for limited resection has not been evaluated. <b><i>Methods:</i></b> In total, 478 NSCLC patients with clinical stage IA disease were analyzed, among whom 383 were used to perform a sub-analysis. <b><i>Results:</i></b> Multivariate analysis showed that consolidation diameter (odds ratio [OR]: 3.05, <i>p</i> = 0.01), SUV_max (OR: 10.74, <i>p</i> = 0.02), and lymphatic invasion (OR: 10.34, <i>p</i> &lt; 0.01) were risk factors for lymph node metastasis in clinical stage IA NSCLC patients. Furthermore, age (OR: 2.98, <i>p</i> = 0.03), SUV_max (OR: 13.07, <i>p</i> = 0.02), and lymphatic invasion (OR: 5.88, <i>p</i> = 0.02) were risk factors for lymph node metastasis in clinical stage IA lung adenocarcinoma patients according to multivariate analysis. <b><i>Conclusion:</i></b> Consolidation diameter of a tumor on CT, SUV_max, and lymphatic invasion are risk factors for lymph node metastasis. However, SUV_max was a risk factor for lymph node metastasis rather than consolidation diameter on CT in lung adenocarcinoma patients. These results suggest that for early-stage lung adenocarcinoma patients, SUV_max is more important for deciding the indication of limited resection than consolidation diameter of the tumor on CT.