ArticleAnnals of surgical oncology2026
Incremental Prognostic Value of Preoperative SUVmax Beyond Size-Based T Descriptors in Pathologic Stage IA Lung Adenocarcinoma.
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- ASO Author Reflections: Precision Robotic Anatomical Segmentectomy 8 Using a Hepatic Vein-Guided and Image-Guided Approach.Annals of surgical oncology · 2026Article
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Authors and funding
5 authors.
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Abstract
backgroundThis study aimed to identify which single clinicopathologic or metabolic indicator most effectively defines a high-risk subgroup beyond size-based T descriptors.
methodsThe study retrospectively analyzed 1198 patients with pathologic stage IA lung adenocarcinoma who underwent lobectomy with mediastinal lymph node dissection between 2007 and 2021. The rule-in performance of each risk factor was assessed by comparing the 5-year cumulative incidence of recurrence in high-risk groups defined by the optimal threshold for each variable. Net reclassification improvement was used to quantify incremental prognostic value beyond T descriptors.
resultsThe median follow-up period was 54 months (interquartile range [IQR], 35-76 months), and the overall 5-year cumulative incidence of recurrence was 4.4%. Among all the variables tested, SUVmax yielded the highest 5-year recurrence rate in its high-risk group: patients with an SUVmax of 6.0 or higher had a 5-year cumulative recurrence incidence of 25.4%. In the multivariable Fine-Gray analysis, SUVmax was the only variable that retained independent prognostic significance (adjusted subdistribution hazard ratio, 1.058; 95% confidence interval (CI), 1.022-1.095; P = 0.001) and the only factor that significantly improved risk reclassification beyond T descriptors in the categorical net reclassification improvement analysis (net reclassification improvement, 0.346; P = 0.008).
conclusionsAmong established prognostic factors, SUVmax demonstrated the most consistent rule-in performance for identifying patients with pathologic stage IA lung adenocarcinoma at elevated recurrence risk, providing incremental prognostic value beyond size-based T descriptors. An SUVmax threshold of ≥ 6.0 identified a subgroup with a 5-year cumulative incidence of recurrence exceeding 25%, who may warrant intensified surveillance and prospective evaluation in perioperative systemic therapy trials.
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