High nodal FDG uptake increases risk of distant metastasis in patients with oropharyngeal squamous cell carcinoma

Jensen, Jan H.; Christensen, J.T.; Håkansson, Kjell Erik Julius; Garset‐Zamani, Martin; Vogelius, I.R.; Löfgren, Johan; Fischer, Barbara; Friborg, Jeppe; Buchwald, Christian von; Rasmussen, Jacob

doi:10.1007/s00259-019-04572-5

Cited by 2 publications

(6 citation statements)

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“… 5 However, a recent study did not find a significant correlation between high 18 FDG uptake in the primary tumor and T-site recurrence using same acquisition protocol in a competing risk scenario. 6 The authors suspected that the effect of a high 18 FDG uptake may already be accounted for by inclusion of T-stage in their model. 6 We have also found that SUVmax of the most avid neck node at baseline is an independent risk factor for recurrence with a cutoff greater than 6.2.…”

Section: Discussionmentioning

confidence: 99%

“… 6 The authors suspected that the effect of a high 18 FDG uptake may already be accounted for by inclusion of T-stage in their model. 6 We have also found that SUVmax of the most avid neck node at baseline is an independent risk factor for recurrence with a cutoff greater than 6.2. This indicates higher metastatic tumor burden in the involved node and presence of nodal metastasis at baseline reduces long-term survival by 50%.…”

Section: Discussionmentioning

confidence: 99%

“…9 Our data are in concordance with a recent study that reveals that high nodal FDG uptake (SUVmax) increases risk of distant metastasis in patients with HNOP-SCC. 6 They found that model including 18 FDG uptake (SUVmax) had a significantly better absolute risk prediction (Brier score) for M-site recurrence compared with the model without SUVmaxN. 6 Another published study revealed that baseline SUVmax of neck node is a poor prognostic marker.…”

Section: Discussionmentioning

confidence: 99%

“… 6 They found that model including 18 FDG uptake (SUVmax) had a significantly better absolute risk prediction (Brier score) for M-site recurrence compared with the model without SUVmaxN. 6 Another published study revealed that baseline SUVmax of neck node is a poor prognostic marker. 17 However, a recent study from India failed to find a significant influence of baseline SUVmax of node on overall survival or DFS.…”

Section: Discussionmentioning

confidence: 99%

“… 4 In many HN-SCC studies, various 18 FDG PET/CT metabolic markers (like standardized uptake value [SUV] of primary tumor and nodes, metabolic tumor volume [MTV], total lesion glycolysis [TLG]) and morphological parameters (likely primary tumor size; Ts and volume) have been identified as valuable imaging markers to assess treatment response and long-term survival. 5 6 …”

Section: Introductionmentioning

confidence: 99%

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Impact of Primary Tumor Size, SUVmax of Primary Tumor and the Most Avid Neck Node on Baseline 18FDG PET/CT upon Disease Recurrence in Head and Neck Oropharyngeal SCC Using Standardized Imaging Protocol

Fatima

Zaman

et al. 2022

World J Nucl Med

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Objective The purpose fo this prospective study was to find the impact of primary tumor size (Ts), standardized uptake values (SUVmax) of primary tumor, and the most avid neck node on disease recurrence in patients with head and neck oropharyngeal squamous cell carcinoma (HNOP-SCC). Material and methods We included patients with HNOP-SCC (without distant metastasis—M0 disease) who had pre- and post-treatment F-18 fluorodeoxyglucose positron emission tomography/computed tomography (18FDG PET/CT) using strict standardized imaging protocol from 2017 to 2019. Based on follow-up (18FDG PET/CT) findings, patients were categorized as disease free (no or minimal 18FDG uptake ≤ background over surgical bed and no distant metastasis) and disease recurrence (18FDG uptake > background over surgical bed with or without nodal and/or distant metastasis). Ts and SUVmax of primary tumor and the most avid neck node were compared and impact of these was studied upon disease recurrence. Results Total 112 patients were included. No significant difference was seen in mean age (overall: 60 ± 14 years), gender distribution (overall M:F: 69:31%), body mass index (overall: 25.20 ± 5.82), and history of diabetes (overall: 19%) between disease-free and disease recurrence groups. Similarly, no significant difference was observed for fasting blood sugar (overall: 110 ± 28 mg%), 18FDG dose (overall: 169 ± 37 MBq), and uptake period (overall: 70 ± 12 minutes) between two groups ensuring strict adherence to standardized imaging protocol. Significant difference (p < 0.05) was observed between disease-free and disease recurrence for Ts (25 ± 10 vs. 33 ± 14 mm), SUVmax of primary tumor (6.2 ± 6.8 vs. 9.3 ± 7.2) and the most avid neck node (2.1 ± 3.3 vs. 4.7 ± 5.9) and median follow-up (13 ± 12 vs. 08 ± 13 months), respectively. Using receiver operating characteristic analysis, Ts greater than 29 mm, baseline tumor SUVmax greater than 4.6, and nodal SUVmax greater than 6.2 were found independent predictors for disease recurrence. Nodal SUVmax greater than 6.2 was found an independent predictor of shortest disease-free survival (DFS) than Ts and tumor SUVmax. Conclusion We conclude that in HNOP-SCC, primary Ts (> 29 mm), SUVmax of primary tumor (> 4.6), and the most avid neck node (> 6.2) in baseline 18FDG PET/CT using standardized imaging protocol are the independent predictors of disease recurrence. Furthermore, SUVmax greater than 6.2 of the most avid node predicts the shortest DFS than primary Ts and SUVmax of primary tumor.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%