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
Original Article

DOI: 10.1007/s00259-009-1180-3

Cite this article as:
Liao, CT., Chang, J.TC., Wang, HM. et al. Eur J Nucl Med Mol Imaging (2009) 36: 1783. doi:10.1007/s00259-009-1180-3

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.

Keywords

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

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Chun-Ta Liao
    • 1
    • 2
    • 3
  • Joseph Tung-Chieh Chang
    • 3
    • 4
  • Hung-Ming Wang
    • 3
    • 5
  • Shu-Hang Ng
    • 3
    • 6
  • Shiang-Fu Huang
    • 1
    • 2
    • 3
  • I-How Chen
    • 1
    • 2
    • 3
  • Chuen Hsueh
    • 3
    • 7
  • Li-Yu Lee
    • 3
    • 7
  • Chih-Hung Lin
    • 3
    • 8
  • Ann-Joy Cheng
    • 3
    • 9
  • Tzu-Chen Yen
    • 3
    • 10
    • 11
  1. 1.Department of OtorhinolaryngologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan (R.O.C.)
  2. 2.Department of Head and Neck SurgeryChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan (R.O.C.)
  3. 3.Head and Neck Oncology Group, Cancer CenterChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan (R.O.C.)
  4. 4.Radiation OncologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan (R.O.C.)
  5. 5.Hema-OncologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan (R.O.C.)
  6. 6.Diagnostic RadiologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan (R.O.C.)
  7. 7.PathologyChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan (R.O.C.)
  8. 8.Plastic and Reconstructive SurgeryChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan (R.O.C.)
  9. 9.Medical Biotechnology, Biostatistics Consulting Center/Department of Public HealthChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan (R.O.C.)
  10. 10.Nuclear Medicine and Molecular Imaging CenterChang Gung Memorial Hospital and Chang Gung UniversityTaoyuanTaiwan (R.O.C.)
  11. 11.Department of Nuclear MedicineChang Gung Memorial Hospital at LinkoTaoyuanTaiwan (R.O.C.)

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