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Preoperative [18F]-fluorodeoxyglucose positron emission tomography standardized uptake value of neck lymph nodes may aid in selecting patients with oral cavity squamous cell carcinoma for salvage therapy after relapse.
- Source :
-
European journal of nuclear medicine and molecular imaging [Eur J Nucl Med Mol Imaging] 2009 Nov; Vol. 36 (11), pp. 1783-93. Date of Electronic Publication: 2009 Jun 04. - Publication Year :
- 2009
-
Abstract
- Purpose: Relapse of tumours in patients with oral cavity squamous cell carcinoma (OSCC) is associated with a dismal outcome. In this prospective study, we sought to investigate the clinical significance of the preoperative maximal standardized uptake value (SUVmax) at the neck lymph nodes in selecting patients with OSCC for salvage therapy after relapse.<br />Methods: Between 2002 and 2007, 108 patients with early relapse of OSCC (n=75) or late relapse of OSCC (n=33) were identified. Salvage therapy was performed in 47 patients. All patients underwent 2-deoxy-2[(18)F]-fluoro-D: -glucose positron emission tomography during the 2 weeks before surgery and neck dissection. All patients were followed for 12 months or more after surgery or until death. The optimal cut-off value for the neck lymph node SUVmax (SUVnodal-max) was selected according to the 5-year disease-specific survival (DSS) rate. Independent risk factors were identified by Cox regression analysis.<br />Results: The mean follow-up for all patients was 20.3 months (41.1 months for surviving patients). In the early relapse group, several prognostic factors were identified in univariate and multivariate analyses, including a SUVnodal-max value of >or=4.2. A scoring system based on univariate analysis was formulated. Patients with a score of 0 had a better 5-year DSS than those with scores of 1 or higher (58% vs. 5%, p=0.0003). In patients with late relapse, a SUVnodal-max value of >or=4.2 had the highest prognostic value for predicting the 5-year DSS (45% vs. 0%, p=0.0005).<br />Conclusion: Among patients with relapsed OSCC, the SUVnodal-max value may aid in selecting patients for salvage therapy.
- Subjects :
- Carcinoma, Squamous Cell diagnostic imaging
Carcinoma, Squamous Cell metabolism
Carcinoma, Squamous Cell surgery
Female
Humans
Lymph Nodes diagnostic imaging
Male
Mouth pathology
Mouth Neoplasms diagnostic imaging
Mouth Neoplasms metabolism
Mouth Neoplasms surgery
Multivariate Analysis
Positron-Emission Tomography
Prognosis
Recurrence
Risk Factors
Salvage Therapy
Survival Analysis
Time Factors
Carcinoma, Squamous Cell therapy
Fluorodeoxyglucose F18 metabolism
Lymph Nodes metabolism
Mouth Neoplasms therapy
Neck
Patient Selection
Preoperative Period
Subjects
Details
- Language :
- English
- ISSN :
- 1619-7089
- Volume :
- 36
- Issue :
- 11
- Database :
- MEDLINE
- Journal :
- European journal of nuclear medicine and molecular imaging
- Publication Type :
- Academic Journal
- Accession number :
- 19495747
- Full Text :
- https://doi.org/10.1007/s00259-009-1180-3