Abstract
BackgroundMetabolic tumour volume (MTV) obtained from pre-treatment 18 F-fluorodeoxydeglucose positron emission tomography with computed tomography (PET-CT) has been validated as an independent predictive factor of outcomes in head and neck cancer patients (HNC) treated with primary chemoradiotherapy (CRT). However its role in patients treated with primary surgery has not yet been studied.ObjectiveTo evaluate the prognostic value of MTV in patients treated with primary surgery for oral cavity squamous cell carcinoma (OCSCC).MethodDemographic and survival data was obtained from patients diagnosed with OCSCC from 2008-2012 in Alberta, Canada. All patients included in the study had PET-CT scan before curative surgical resection. MTV and maximum standardized uptake value (SUVmax) value was delineated from pre-treatment PET-CT scans using Segami Oasis software (Columbus, OH). MTV and SUVmax were divided into intertertile thirds before statistical analysis to allow for in-group comparison of survival.ResultsA total of 80 patients were analyzed using SPSS ver. 20.0 (SPSS Inc, Chicago, IL). Five-year overall, and disease-free survival using Kaplan-Meier curves were 70% and 73% respectively. When the combined SUVmax (tumour primary and locoregional metastasis) was evaluated, it failed to predict overall (HR = 1.0, p = 0.99) or disease-free survival (HR = 1.0, p = 0.227).Conversely an increase in MTV of 17.5 mL (difference between the highest and lowest MTV tertile) was associated with a 12.4 fold increase in risk of disease recurrence (p < 0.001) and an 11.2 fold increase in the risk of death (p < 0.05).ConclusionsThis study shows that MTV is an independent adverse prognostic factor for death and disease recurrence in OCSCC treated with primary surgery.
Highlights
Head and Neck cancer (HNC) accounts for 5% of all malignancies worldwide with oral cavity squamous cell carcinoma (OCSCC) being the most common site of occurrence [1,2]
This study shows that Metabolic tumour volume (MTV) is an independent adverse prognostic factor for death and disease recurrence in OCSCC treated with primary surgery
Metabolic tumour volume (MTV) calculated as the product of the SUVmax and tumour volume has recently been validated as an independent predictive factor of outcomes in head and neck cancer patients (HNC) treated with primary chemoradiotherapy (CRT) [5]
Summary
Head and Neck cancer (HNC) accounts for 5% of all malignancies worldwide with oral cavity squamous cell carcinoma (OCSCC) being the most common site of occurrence [1,2]. 18 F-fluorodeoxydeglucose positron emission tomography with computed tomography (PET-CT) plays a major role in the management of HNC patients owing largely to its ability to systematically measure tumour burden [7,8,9,10] As a result it has become the standard of care in many centers for staging, evaluation of nodal and distant metastasis as well as key roles in radiation planning [7,10,11]. Metabolic tumour volume (MTV) calculated as the product of the SUVmax and tumour volume has recently been validated as an independent predictive factor of outcomes in head and neck cancer patients (HNC) treated with primary chemoradiotherapy (CRT) [5]. Metabolic tumour volume (MTV) obtained from pre-treatment 18 F-fluorodeoxydeglucose positron emission tomography with computed tomography (PET-CT) has been validated as an independent predictive factor of outcomes in head and neck cancer patients (HNC) treated with primary chemoradiotherapy (CRT). Its role in patients treated with primary surgery has not yet been studied
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