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Volume-based 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters correlate with delayed neck metastasis in clinical early-stage oral squamous cell carcinoma

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Abstract

Objective

There is no known preoperative marker that can effectively predict the risk of delayed neck metastasis (DNM), which is an important factor that determines the prognosis of early-stage oral cancer. In this study, we examined whether 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET)/computed tomography (CT) uptake parameters of primary cancer can predict the risk of DNM in early-stage oral squamous cell carcinoma (OSCC).

Methods

Data from patients with stage I–II OSCC who underwent surgical resection of the primary tumor without elective neck dissection between January 2009 and December 2016 were retrospectively reviewed. Patient characteristics, histopathological factors, and PET/CT parameters (maximum standardized uptake value [SUVmax], metabolic tumor volume [MTV], and total lesion glycolysis [TLG]) were evaluated for their association with DNM. DNM rates were calculated, and the parameters that were statistically significant in the univariate analysis were used as explanatory variables. Independent factors associated with DNM were identified using multivariate analysis. For all statistical analyses, p-values < 0.05 were considered statistically significant.

Results

Data from 71 patients were analyzed in the study. The overall DNM rate among all patients was 21.8%. The univariate analysis showed that the T classification, depth of invasion, pattern of invasion, lymphovascular invasion, SUVmax, MTV, and TLG were significant predictors of DNM. However, the multivariate analysis revealed that only the depth of invasion, MTV, and TLG were independent predictors of DNM.

Conclusion

This study suggests that, in addition to conventional predictors, volume-based PET parameters are useful predictors of DNM in those with early-stage OSCC.

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Data availability

The data that support the findings of this study are available from the corresponding author on request. The data are not publicly available due to privacy or ethical restrictions.

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Acknowledgements

We acknowledge the support of Dr. Yuu Tanaka from the Department of Rehabilitation, Faculty of Health Science, Wakayama Professional University of Rehabilitation for assistance with statistical analyses. We wish to thank Editage (http://www.editage.jp/) for English-language editing.

Funding

This study did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, School of Medicine, Nara Medical University, 840 Shijo-Cho, Kashihara, Nara, 634-8522, Japan

    Nobuhiro Yamakawa, Yohei Nakayama, Nobuhiro Ueda, Takahiro Yagyuu, Shigehiro Tamaki & Tadaaki Kirita

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  1. Nobuhiro Yamakawa
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  2. Yohei Nakayama
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Contributions

Nobuhiro Yamakawa and Tadaaki Kirita contributed to the study conception and design. Material preparation and data collection were performed by Yohei Nakayama, Nobuhiro Ueda, and Takahiro Yagyuu. Analyses were performed by Nobuhiro Yamakawa and Shigehiro Tamaki. The first draft of the manuscript was written by Nobuhiro Yamakawa and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Nobuhiro Yamakawa.

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All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2008. The study protocol was approved by the Ethics Committee of Nara Medical University (approval number: 2339).

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Informed consent was waived by the local Ethics Committee of Nara Medical University in view of the retrospective nature of the study.

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Yamakawa, N., Nakayama, Y., Ueda, N. et al. Volume-based 18F-fluorodeoxyglucose positron emission tomography/computed tomography parameters correlate with delayed neck metastasis in clinical early-stage oral squamous cell carcinoma. Oral Radiol 39, 668–682 (2023). https://doi.org/10.1007/s11282-023-00686-7

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