Prognostic Role of ERCC1 Protein Expression and its Correlation with 18F-FDG Uptake on PET in Patients with Resected Non-Small Cell Lung Cancer

ERCC1 is a protein which is found to be associated with resistance to platinum-based chemotherapy. FDG uptake is considered as a prognostic marker in patients with NSCLC and provides information beyond that of TNM staging. The aim of this study is to examine both prognostic values of ERCC1 expression and 18F-FDG uptake on PET and their relationship in patients who underwent pulmonary resection for NSCLC. Although high expression of ERCC1 was found to be associated with better survival, the difference was not considered as statistically significant (p= 0.067). There is a significant survival advantage in ERCC1 (+) patients who did not receive adjuvant therapy (p= 0.047). High maximal standard uptake value (SUVmax) was found to be associated with poor survival (hazard ratio [HR]: 1.10; 95% CI, 1.02-1.18; p= 0.009). Correlation between ERCC1 expression and mean SUVmax was statistically insignificant (p= 0.915). Among patients with SUVmax >= 2.5, ERCC1 positivity was 57.4% in patients who survived and 29.4% in patients who died which was statistically significant (p= 0.048). The association between high 18F-FDG uptake on PET and poor outcome was confirmed, but we failed to detect a powerful correlation between ERCC1 expression and SUVmax.