Abstract
The purpose of this study was to assess the relationship between F-18 fluorodeoxyglucose (FDG) uptake in bone marrow (BM) on positron emission tomography/computed tomography (PET/CT) and survival in patients with head and neck squamous cell carcinoma (HNSCC). We retrospectively enrolled 157 HNSCC patients who underwent staging FDG PET/CT and subsequent treatment. On PET/CT, primary tumor metabolic characteristics, mean FDG uptake of BM (BM SUV), and BM-to-liver uptake ratio (BLR) were measured. The prognostic significance of FDG uptake of BM for predicting disease progression-free survival and distant failure-free survival was assessed using a Cox proportional hazards regression model. In univariate analysis for disease progression-free survival, increased BM SUV and BLR were associated with poor survival. In multivariate analysis, BLR (p = 0.044; hazard ratio, 1.96), TNM stage (p = 0.014; hazard ratio, 2.87) and maximum FDG uptake of the primary tumor (p = 0.046; hazard ratio, 2.38) were independently associated with disease progression-free survival. For distant failure-free survival, BLR, TNM stage, tumor size, and metabolic parameters of the primary tumor showed prognostic significance in univariate analysis. However, none of the variables showed significance in multivariate analysis. FDG uptake of BM in HNSCC patients might be a significant predictor for disease progression-free survival. Further studies with large patient population are needed to validate the results.
Highlights
Chronic inflammation induced by infection is strongly correlated with the development of cancer
We measured FDG uptake of the bone marrow (BM) in positron emission tomography/computed tomography (PET/CT) images obtained in patients diagnosed with head and neck squamous cell carcinoma (HNSCC) and showed that FDG uptake of the BM was significantly associated with serum inflammatory markers, FDG PET parameters of the primary tumor, clinical stage, and disease progression-free survival
Given that the degree of inflammatory response is related to the prognosis in patients with HNSCC [6,28,29], we evaluated the prognostic value of BM standardized uptake value (SUV) and BM-to-liver uptake ratio (BLR) in the present study
Summary
Chronic inflammation induced by infection is strongly correlated with the development of cancer. Because of the significant link between the inflammatory reaction and tumor progression, NLR, PLR, and CRP have been found to have significant prognostic value for predicting survival in diverse cancers including head and neck squamous cell carcinoma (HNSCC) [5,6,7,8]. Based on these results, biomarkers for a systemic inflammatory response are considered to be a tool for predicting clinical outcomes in malignant diseases [5,6,7,8]
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