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

Chun Ta Liao, Joseph Tung Chieh Chang, Hung Ming Wang, Shu Hang Ng, Shiang Fu Huang, I. How Chen, Chuen Hsueh, Li Yu Lee, Chih Hung Lin, Ann Joy Cheng, Tzu Chen Yen*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

19 Scopus citations

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. 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[18F]-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. 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 ≥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 ≥4.2 had the highest prognostic value for predicting the 5-year DSS (45% vs. 0%, p=0.0005). Conclusion: Among patients with relapsed OSCC, the SUVnodal-max value may aid in selecting patients for salvage therapy.

Original languageEnglish
Pages (from-to)1783-1793
Number of pages11
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume36
Issue number11
DOIs
StatePublished - 2009

Keywords

  • FDG PET
  • Lymph node
  • Oral cavity squamous cell carcinoma
  • Salvage therapy
  • Standardized uptake value

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