The percentage of maximum standardized uptake value remaining in the primary tumor after induction chemotherapy (%SUVremaining) may be a predictor for survival and other endpoints after multimodality treatment in patients with operable, locally advanced non-small cell lung cancer (NSCLC), according to a study published in the Journal of Clinical Oncology.1

Martin Stuschke, MD, of the University Hospital Essen in Germany randomly assigned 161 patients with potentially operable stage 3A(N2) or selected stage 3B NSCLC to either definitive neoadjuvant radiochemotherapy (RCT) or surgery, 124 patients received positron emission tomography scans before and after induction chemotherapy.

The prognostic value of %SUVremaining was assessed through proportional hazard analysis and receiver operating characteristic analysis.

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Researchers found that %SUVremaining as a continuous variable was prognostic for the endpoints of overall survival, progression-free survival, and freedom from extracerebral progression in univariable and multivariable analysis. When dichotomized at a cut point of maximum sum of sensitivity and specificity from receiver operating characteristic analysis at 36 months, %SUVremaining was also prognostic.

Hazard ratios per 50% increase in %SUVremaining from multivariable analysis were 2.3 for overall survival, 1.8 for progression-free survival, and 1.8 for freedom from extracerebral progression.

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Upon exploratory analysis, %SUVremaining was found to be similarly prognostic for overall survival in both treatment arms and more closely associated with extracerebral distant metastases than with isolated locoregional relapses.


  1. Pöttgen C, Gauler T, Bellendorf A, Guberina M, Bockisch A, Schwenzer N, et al. Standardized uptake decrease on [18F]-fluorodeoxyglucose positron emission tomography after neoadjuvant chemotherapy is a prognostic classifier for long-term outcome after multimodality treatment: secondary analysis of a randomized trial for resectable stage IIIA/B non–small-cell lung cancer [published online ahead of print May 31, 2016]. J Clin Oncol. doi: 10.1200/JCO.2015.65.5167.