Original Article
Prognostic effects of the metabolic tumor volume and total lesion glycolysis in patients with advanced squamous cell carcinoma of head and neck
Abstract
Background: To investigate the prognostic significance of quantitative parameters obtained from pre-treatment 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) scan on patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN).
Methods: Fifty patients with previously untreated, biopsy-proven, stage III–IV SCCHN who received induction chemotherapy (indCT) followed by local treatment (surgery, radiotherapy or both) were enrolled. We analyzed prognostic effects of the maximum standardized uptake value (SUVmax) of the primary tumor, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) along with clinicopathological variables on treatment outcomes.
Results: After a median follow-up of 44 months, locoregional recurrence and distant metastasis were observed in 13 and 3 patients, respectively. The SUVmax of the primary tumor and all analyzed clinicopathological characteristics had no correlation with treatment outcome. Both MTV and TLG were significant predictors for overall survival (OS) and locoregional progression-free survival (LRPFS) by both univariate and multivariate analyses, the 3-year rates of OS and LRPFS for patients with pre-treatment MTV < vs. ≥85 were 78.8% vs. 33.9% (P=0.0200) and 80.2% vs. 47.6% (P=0.0235). Similar results were obtained for the pre-treatment TLG (< vs. ≥620 were 78.8% vs. 34.6% for OS, P=0.0125; and were 80.9% vs. 43.1% for LRPFS, P=0.0106).
Conclusions: The pretreatment MTV and TLG are independent predictors for OS and LRPFS in patients with advanced SCCHN.
Methods: Fifty patients with previously untreated, biopsy-proven, stage III–IV SCCHN who received induction chemotherapy (indCT) followed by local treatment (surgery, radiotherapy or both) were enrolled. We analyzed prognostic effects of the maximum standardized uptake value (SUVmax) of the primary tumor, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) along with clinicopathological variables on treatment outcomes.
Results: After a median follow-up of 44 months, locoregional recurrence and distant metastasis were observed in 13 and 3 patients, respectively. The SUVmax of the primary tumor and all analyzed clinicopathological characteristics had no correlation with treatment outcome. Both MTV and TLG were significant predictors for overall survival (OS) and locoregional progression-free survival (LRPFS) by both univariate and multivariate analyses, the 3-year rates of OS and LRPFS for patients with pre-treatment MTV < vs. ≥85 were 78.8% vs. 33.9% (P=0.0200) and 80.2% vs. 47.6% (P=0.0235). Similar results were obtained for the pre-treatment TLG (< vs. ≥620 were 78.8% vs. 34.6% for OS, P=0.0125; and were 80.9% vs. 43.1% for LRPFS, P=0.0106).
Conclusions: The pretreatment MTV and TLG are independent predictors for OS and LRPFS in patients with advanced SCCHN.
