Abstract
The aim of this study is to assess the influence of semiquantitative PET-derived parameters as well as hematological parameters in overall survival in HNSCC patients using neural network analysis. Retrospective analysis was performed on 106 previously untreated HNSCC patients. Several PET-derived parameters (SUVmax, SUVmean, TotalSUV, MTV, TLG, TLRmax, TLRmean, TLRTLG, and HI) for primary tumor and lymph node with highest activity were assessed. Additionally, hematological parameters (LEU, LEU%, NEU, NEU%, MON, MON%, PLT, PLT%, NRL, and LMR) were also assessed. Patients were divided according to the diagnosis into the good and bad group. The data were evaluated using an artificial neural network (Neural Analyzer version 2.9.5) and conventional statistic. Statistically significant differences in PET-derived parameters in 5-year survival rate between group of patients with worse prognosis and good prognosis were shown in primary tumor SUVmax (10.0 vs. 7.7; p = 0.040), SUVmean (5.4 vs. 4.4; p = 0.047), MTV (23.2 vs. 14.5; p = 0.010), and TLG (155.0 vs. 87.5; p = 0.05), and mean liver TLG (27.8 vs. 30.4; p = 0.031), TLRmax (3.8 vs. 2.6; p = 0.019), TLRmean (2.8 vs. 1.9; p = 0.018), and in TLRTLG (5.6 vs. 2.3; p = 0.042). From hematological parameters, only LMR showed significant differences (2.5 vs. 3.2; p = 0.009). Final neural network showed that for ages above 60, primary tumors SUVmax, TotalSUV, MTV, TLG, TLRmax, and TLRmean over (9.7, 2255, 20.6, 145, 3.6, 2.6, respectively) are associated with worse survival. Our study shows that the neural network could serve as a supplement to PET-derived parameters and is helpful in finding prognostic parameters for overall survival in HNSCC.
Highlights
Most oral cavity and larynx tumors are associated with alcohol and tobacco intake, while oropharynx are linked with human papilloma virus (HPV) infection [2]
Our analysis suggests that from all assessed metabolic parameters, only SUVmax and SUVmean of the hottest lymph node showed a significant difference in N3 stage compared with other N-stages
We have shown that mean liver total lesion glycolysis (TLG) and TLRTLG are significantly different between patients with good and worse prognosis
Summary
Head and neck squamous cell carcinoma (HNSCC) originally develop from the mucosal epithelium in the oral cavity, pharynx, and larynx and is the sixth most common creativecommons.org/licenses/by/ 4.0/). Head and neck squamous cell carcinoma (HNSCC) originally develop from the mucosal epithelium in the oral cavity, pharynx, and larynx and is the sixth most common cancer worldwide, with 890,000 new cases and 450,000 deaths in 2018 [1]. Most oral cavity and larynx tumors are associated with alcohol and tobacco intake, while oropharynx are linked with human papilloma virus (HPV) infection [2]. The recent TNM classification mentioned the differences between HPV-positive and HPV-negative patients diagnosed worldwide, with oropharyngeal cancer [3]. The recent TNM classification mentioned the emission differencestomography between HPV-positive patients diagnosed
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