Significance of SUV Max for Predicting Occult Lymph Node Metastasis and Prognosis in Early-Stage Tongue Squamous Cell Carcinoma.

Chunmiao Xu,Hailiang Li,Dongjie Seng,Fei Liu

doi:10.1155/2020/6241637

Abstract

Objective Our goal was to clarify the significance of SUV max for predicting occult lymph node metastasis and prognosis in early-stage tongue squamous cell carcinoma (SCC). Methods cT1-2N0 tongue SCC patients who underwent a preoperative PET-CT examination were prospectively enrolled. The association between SUV max and occult lymph node metastasis was analyzed. The main study endpoint was locoregional control (LRC). The Cox model was used to determine the independent factors. Results A total of 120 patients were included for analysis, and the median SUV max was 9.7. In 60 patients with an SUV max ≤9.7, 5 patients had occult metastasis; in 60 patients with an SUV max >9.7, 13 patients had occult metastasis, and the difference was significant (p=0.041). In patients with an SUV max ≤9.7, the 5-year LRC rate was 93%; in patients with an SUV max >9.7, the 5-year LRC rate was 81%, and the difference was significant (p=0.045). Conclusion An SUV max >9.7 was a marker for occult lymph node metastasis and could decrease LRC in patients with cT1-2N0 tongue SCC.

Highlights

Neck lymph node status is the most important prognostic factor in oral squamous cell carcinoma (SCC), and survival usually decreases by half once there is lymph node metastasis
Researchers who support routine neck dissection describe that it can select patients who need adjuvant radiotherapy and improve survival [1, 2], but others argue that most patients with cT12N0 disease do not have pathologic lymph node metastasis; they are overtreated and exposed to possible neck dissectionrelated complications [3, 4]. erefore, it is important for us to identify reliable predictors of neck lymph node metastasis, and current evidence supports the predictive value of depth of invasion (DOI), perineural invasion (PNI), and lymphovascular invasion (LVI)
Tongue SCC shows different biologic behavior compared to other subsites of SCC; whether SUV max can be used as a marker for occult lymph node metastasis in early-stage tongue SCC remains unknown. erefore, in the current study, we aimed to clarify the significance of SUV max in predicting occult lymph node metastasis and prognosis in early-stage tongue SCC

Summary

Introduction

Neck lymph node status is the most important prognostic factor in oral squamous cell carcinoma (SCC), and survival usually decreases by half once there is lymph node metastasis. Erefore, in the current study, we aimed to clarify the significance of SUV max in predicting occult lymph node metastasis and prognosis in early-stage tongue SCC. Clinical pathologic and follow-up data, including age, sex, smoking status, drinking status, pathologic TNM stage based on the AJCC 8th edition, perineural invasion (PNI), lymphovascular invasion (LVI), extracapsular extension (ECS), depth of invasion (DOI), SUV max of the primary tumor, and SUV max of the lymph node, were recorded for the enrolled patients.

Results

Conclusion