Abstract
We investigated whether 18F-fluorodeoxyglucose uptake parameters using positron emission tomography combined with computed tomography predicts several survival outcomes, including lung metastasis-free survival, in patients with laryngeal or pharyngeal cancer who underwent salvage surgery. The maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis were calculated as 18F-fluorodeoxyglucose uptake parameters in 51 patients with laryngeal or pharyngeal cancer before salvage surgery. In univariate analysis, the maximum standardized uptake value ≥ 22.8, metabolic tumor volume ≥ 2.4, and total lesion glycolysis ≥ 5.4 were significantly correlated with shorter overall survival. In multivariate analysis with adjustment for clinical stage, patients with total lesion glycolysis ≥ 5.4 exhibited significantly shorter overall survival. Furthermore, total lesion glycolysis ≥ 5.4 was significantly correlated with shorter disease-specific survival, distant metastasis-free survival, and lung metastasis-free survival in univariate analysis. In conclusion, total lesion glycolysis predicts the survival outcomes including lung metastasis in patients with laryngeal or pharyngeal cancer who underwent salvage surgery.
Highlights
Salvage surgery is radical therapy for recurrence, residual and metachronous tumors after radiotherapy (RT) with or without chemotherapy in head and neck cancer, including laryngeal or pharyngeal squamous cell carcinoma (LPSCC) [1, 2]
Several pre-or posttreatment 18F-FDG-uptake parameters have been shown to be correlated with the overall survival (OS) in head and neck cancer, including various sites of primary www.oncotarget.com tumor [4,5,6,7,8,9,10], and we have reported in our study of 53 hypopharyngeal cancer that high total lesion glycolysis (TLG) on pretreatment 18F-FDG-positron emission tomography combined with computed tomography (PET/CT) at initial staging is correlated with a shorter OS and distant metastasis-free survival [5]
We showed for the first time that TLG ≥ 5.4 was significantly correlated with a shorter OS in patients with LPSCC who underwent salvage surgery in univariate and multivariate analyses, and TLG ≥ 5.4 was significantly correlated with a shorter www.oncotarget.com disease- specific survival, distant metastasis-free survival, and lung metastasis-free survival in a univariate analysis
Summary
Salvage surgery is radical therapy for recurrence, residual and metachronous tumors after radiotherapy (RT) with or without chemotherapy in head and neck cancer, including laryngeal or pharyngeal squamous cell carcinoma (LPSCC) [1, 2]. The maximum standardized uptake value (SUVmax) is traditionally and semiquantitatively measured as18Ffluorodeoxyglocose (18F-FDG) uptake parameter for primary tumor in various types of cancer; it is assessed by pre- or posttreatment positron emission tomography combined with computed tomography (PET/CT) [4]. Several pre-or posttreatment 18F-FDG-uptake parameters have been shown to be correlated with the overall survival (OS) in head and neck cancer, including various sites of primary www.oncotarget.com tumor [4,5,6,7,8,9,10], and we have reported in our study of 53 hypopharyngeal cancer that high TLG on pretreatment 18F-FDG-PET/CT at initial staging is correlated with a shorter OS and distant metastasis-free survival [5]
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