Preoperative <sup>18</sup>F‐FDG PET/CT and high‐risk HPV in patients with oropharyngeal squamous cell carcinoma

Joo, Young Hoon; Yoo, Ie Ryung; Cho, Kwang-Jae; Park, Jun‐Ook; Nam, In‐Chul

doi:10.1002/hed.23296

Cited by 28 publications

(25 citation statements)

References 19 publications

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“…Although earlier studies of FDG-PET in mixed HNSCC cohorts suggested that pSUV max was predictive for LF and survival after radiotherapy [9, 22, 23] , our findings are consistent with a recent prospective study demonstrating that pre-treatment SUV max lacks predictive value in HPV+ OPC [14] . Similar findings have been shown in a recently published surgical series, in which SUV max failed to predict for disease-specific survival after adjustment for co-variates including HPV status [24] . In contrast to SUV max , which measures the maximal metabolic activity of a single pixel, more global measures such as metabolic tumor volume(MTV) [14] and mean SUV (SUV mean ) [25] have recently been demonstrated as independent predictors of outcome in HNSCC.…”

Section: Discussionsupporting

confidence: 87%

Refining risk stratification for locoregional failure after chemoradiotherapy in human papillomavirus-associated oropharyngeal cancer

et al. 2014

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Background To determine whether the addition of molecular and imaging biomarkers to established clinical risk factors could help predict locoregional failure (LRF) after chemoradiation in human papillomavirus (HPV)-related(+) oropharyngeal cancer (OPC) and improve patient selection for locoregional treatment de-intensification. Methods HPV status was determined for 198 consecutive patients with Stage III/IV OPC treated with definitive chemoradiation from 5/2003–10/2010. The impact of pre-therapy epidermal growth factor receptor (EGFR) overexpression; imaging biomarkers including primary tumor and nodal maximum standardized uptake values on FDG-PET, gross tumor volumes, and matted nodes; and clinical factors on LRF (including residual disease at adjuvant neck dissection) was assessed. Results Primary tumors were HPV+ in 184 patients and HPV-negative in 14. EGFR overexpression was related to HPV-negative status and was univariately associated with LRF in the overall population, but was neither retained in the multivariate model after adjustment for HPV status, nor associated with LRF in HPV+ patients. Similarly, imaging biomarkers were univariately associated with LRF, but correlated with T-stage and/or N-stage and did not remain predictive in HPV+ patients after adjustment for T4- and N3-stages, which were the only significant predictors of LRF on multivariate analysis. Among HPV+ patients with non-T4- or N3-stages, only minimal smoking was associated with decreased LRF. Conclusion(s) The prognostic impact of EGFR overexpression and imaging biomarkers on LRF was predominantly related to their association with HPV-negative status and T- or N-stage, respectively. . Among HPV+ OPC patients treated with uniform chemoradiation, only T4-stage, N3-stage, and smoking contributed to risk-stratification for LRF.

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Section: Discussionsupporting

confidence: 87%

Refining risk stratification for locoregional failure after chemoradiotherapy in human papillomavirus-associated oropharyngeal cancer

et al. 2014

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“…Lin et al showed that a pretreatment SUV max of >11 was a predictor of primary recurrence in 62 patients with pharyngeal cancer treated with RT [31]. A recent report has also shown that a pretreatment SUV max of >7.1 is associated with a poor 5-year DFS in patients with OPSCC treated with initial surgery [32]. However, recent studies have failed to show the association of SUV max with survival outcome in patients with pharyngeal cancers [18,20,22].…”

Section: Discussionmentioning

confidence: 94%

Prognostic significance of standardized uptake value and metabolic tumour volume on 18F-FDG PET/CT in oropharyngeal squamous cell carcinoma

Kim

Roh

et al. 2015

Eur J Nucl Med Mol Imaging

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SUVmax and MTV measured on pretreatment (18)F-FDG PET/CT may be useful in predicting the clinical outcomes in OPSCC patients. This study investigated the clinical prognostic value of imaging parameters from pretreatment (18)F-FDG PET/CT in 221 patients who underwent definitive treatment for oropharyngeal squamous cell carcinoma. High maximum standardized uptake value and metabolic tumour volume were independently associated with decreased disease-free and overall survival outcomes.

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“…Joo 24 studied 78 patients with OP SCC (28 HPV+ and 50 HPV−) and Tahari 25 studied 123 patients (98 HPV+ and 25 HPV−) with OP SCC. Joo 24 found that a median SUV max value of 7.1 for the primary can be used as an adjuvant diagnostic tool for high risk HPV infection, with a sensitivity of 78% and specificity of 68%. They also suggested that HPV negativity is associated with higher median SUV max of the primary tumor.…”

Section: Discussionmentioning

confidence: 99%

Do 18F-FDG PET/CT Parameters in Oropharyngeal and Oral Cavity Squamous Cell Carcinomas Indicate HPV Status?

Kendi¹,

Magliocca²,

Corey³

et al. 2015

Clinical Nuclear Medicine

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Objective To explore the relationship of PET/CT parameters with HPV status of oropharyngeal (OP) and oral cavity (OC) squamous cell carcinomas (SCC). Material and Methods We retrospectively reviewed 39 patients with OC and OP SCC who underwent staging 18F-FDG PET/CT. PET/CT parameters were measured for the primary tumor and the hottest involved node, including maximum, mean, peak standardized uptake values (SUV max, SUV mean, SUV peak), metabolic tumor volume (MTV), total lesion glycolysis (TLG), standardized added metabolic activity (SAM), normalized standardized added metabolic activity (N SAM). Patient characteristics compared between HPV positive (HPV+) and negative (HPV−) groups. ROC analysis was used to dichotomize PET/CT parameters into high and low. Logistic regression models predicting HPV status were fit for each PET/CT parameter. Results The HPV+ group was comprised of 18 patients all with OP SCC; the HPV− group consisted of 21 patients, 4 OP cancer patients and 17 OC cancer patients. The HPV+ group had a higher proportion of N2 stage (94% vs 43%; p<0.001). Nodal PET/CT parameters were higher in the HPV+ group (p<0.01), this difference was not present for the primary lesion. After adjusting for sex and age, the association of higher nodal SUV max (OR 9.67), SUV mean (OR 10.48), SUV peak (OR 9.67), MTV (OR 14.52), TLG (OR 11.84) and SAM, N SAM (OR 16.21) with HPV+ status remained statistically significant (p<0.05). Conclusion Nodal PET/CT parameters predict HPV status. High nodal FDG uptake should raise suspicion for positive HPV status in the evaluation of the primary lesion.

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Preoperative ¹⁸F‐FDG PET/CT and high‐risk HPV in patients with oropharyngeal squamous cell carcinoma

Abstract: Median (18)F-FDG PET/CT SUVmax cutoff values 7.10 or greater are associated with a high-risk HPV negativity in OPSCC patients.

Cited by 28 publications

References 19 publications

Refining risk stratification for locoregional failure after chemoradiotherapy in human papillomavirus-associated oropharyngeal cancer

Refining risk stratification for locoregional failure after chemoradiotherapy in human papillomavirus-associated oropharyngeal cancer

Prognostic significance of standardized uptake value and metabolic tumour volume on 18F-FDG PET/CT in oropharyngeal squamous cell carcinoma

Do 18F-FDG PET/CT Parameters in Oropharyngeal and Oral Cavity Squamous Cell Carcinomas Indicate HPV Status?

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Preoperative 18F‐FDG PET/CT and high‐risk HPV in patients with oropharyngeal squamous cell carcinoma

Abstract: Median (18)F-FDG PET/CT SUVmax cutoff values 7.10 or greater are associated with a high-risk HPV negativity in OPSCC patients.

Cited by 28 publications

References 19 publications

Refining risk stratification for locoregional failure after chemoradiotherapy in human papillomavirus-associated oropharyngeal cancer

Refining risk stratification for locoregional failure after chemoradiotherapy in human papillomavirus-associated oropharyngeal cancer

Prognostic significance of standardized uptake value and metabolic tumour volume on 18F-FDG PET/CT in oropharyngeal squamous cell carcinoma

Do 18F-FDG PET/CT Parameters in Oropharyngeal and Oral Cavity Squamous Cell Carcinomas Indicate HPV Status?

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Preoperative ¹⁸F‐FDG PET/CT and high‐risk HPV in patients with oropharyngeal squamous cell carcinoma