Prognostic value of 18 F-FDG PET/CT parameters in patients who undergo salvage treatments for recurrent squamous cell carcinoma of the larynx and hypopharynx.

Abstract

Recurrent laryngeal/hypopharyngeal squamous cell carcinoma (LHSCC) is commonly associated with poor survival outcomes. We evaluated the prognostic role of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) parameters quantitatively measured in patients who underwent salvage treatments for recurrent LHSCC. This study involved 100 consecutive LHSCC patients who underwent 18 F-FDG PET/CT for recurrent staging and subsequent salvage treatments. Maximum standardized uptake value (SUVmax ), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured using 18 F-FDG PET/CT. Cox proportional hazards regression analyses were used to assess the associations between quantitative 18 F-FDG PET/CT parameters and other clinicopathological factors with progression-free survival (PFS) and overall survival (OS). Two-year postsalvage PFS and OS rates were 67.9% and 74.3%, respectively. All 18 F-FDG PET parameters of SUVmax , MTV, and TLG were significantly associated with poor PFS and OS outcomes after salvage treatment (all P < 0.05). Multivariate analyses revealed that recurrence site, MTV (>6.5 mL), and TLG (>17.1 g) were independent variables predictive of PFS. Karnofsky score, SUVmax (>4.0), and TLG (>17.1 g) were the independent prognostic factors for OS. 18 F-FDG PET/CT can be useful in predicting postsalvage recurrence and survival in patients with recurrent LHSCC.