Total lesion glycolysis in oral squamous cell carcinoma as a biomarker derived from pre-operative FDG PET/CT outperforms established prognostic factors in a newly developed multivariate prediction model

Abstract

Purpose: Retrospective study to investigate the impact of image derived biomarkers from [ 18 F]FDG PET/CT prior to surgical resection in patients with initial diagnosis of oral squamous cell carcinoma (OSCC), namely SUV max , SUV mean , metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of the primary tumor to predict overall survival (OS). Materials and Methods: 127 subsequent patients with biopsy-proven OSCC were included who underwent [ 18 F]FDG PET/CT before surgery. SUV max , SUV mean , MTV and TLG of the primary tumor were measured. OS was estimated according to Kaplan-Meier and compared between median-splitted groups by the log-rank test. Prognostic parameters were analyzed by uni-/multivariate Cox-regression. Results: During follow-up 52 (41%) of the patients died. Median OS was longer for patients with lower MTV or lower TLG. SUV max and SUV mean failed to be significant predictors for OS. Univariate Cox-regression identified MTV, TLG, lymph node status and UICC stage as prognostic factors. By multivariate Cox-regression MTV and TLG turned out to be independent prognostic factors for OS. Conclusions: The pre-therapeutic [ 18 F]FDG PET/CT parameters MTV and TLG in the primary tumor are prognostic for OS of patients with an initial diagnosis of OSCC. TLG is the strongest independent prognostic factor for OS and outperforms established prognostic parameters in OSCC.

Implications of Standardized Uptake Values of Oral Squamous Cell Carcinoma in PET-CT on Prognosis, Tumor Characteristics and Mitochondrial DNA Heteroplasmy

“…In line with previous studies demonstrating a correlation between metabolic activity, survival and clinicopathological features in OSCC [ 48 , 49 , 51 , 52 ], we were able to confirm these findings in the present study. Analysis of SUVmax values among patients with OSCC—divided into two groups according to a statistically calculated cut-off value—showed highly significant differences in survival, with higher survival rates in the low SUVmax group.…”

“…Berghmans et al also highlighted this connection early in their review of the predictive value of SUVmax on survival times in patients with non-small-cell lung cancer (NSCLC) and identified a survival-dependent threshold for SUVmax [ 44 ]. In further studies on OSCC, the same correlations were observed [ 36 , 48 , 49 , 50 , 51 ]. Based on these pre-existing studies, we evaluated a potential survival-dependent impact of SUVmax for OSCC patients and established a tumor-specific threshold by use of ROC analyses.…”

18F-FDG PET/CT-derived total lesion glycolysis predicts abscess formation in patients with surgically confirmed infective endocarditis: Results of a retrospective study at a tertiary center

“…While MV 4 , 9 – 14 , 21 , 22 and TLG (SUV) have been extensively studied in the context of oncological disorders, our current study is one of the few that investigates the diagnostic performance of these 18 F-FDG PET/CT-derived PET parameters (or their SUR-based variant) in the context of IE. In that regard, Avramovic et al have previously compared the diagnostic value of MV with SUVmax in patients with left ventricular assist devices (LVADs).…”

Salivary Metabolomics for Prognosis of Oral Squamous Cell Carcinoma

“…OSCC staging, including the TN-stage, and surgical margin status are the most established clinical prognostic factors ( 19 ). Imaging-based biomarkers, including CT, magnetic resonance imaging, and F-fluorodeoxyglucose positron emission tomography/CT parameters, are established prognostic factors for OSCC ( 20 , 21 ). Recently, molecular biomarkers quantified through liquid and tissue biopsy have been reported ( 2 , 22 , 23 ).…”