Prognostic significance of the intratumoral heterogeneity of (18) F-FDG uptake in oral cavity cancer.

Abstract

BACKGROUNDS: We evaluated the prognostic value of the intratumoral heterogeneity

of (18) F-FDG uptake in oral cavity cancer. MATERIALS AND METHODS: We enrolled 45

patients who underwent pretreatment (18) F-FDG PET/CT. The intratumoral

heterogeneity of (18) F-FDG uptake was represented as the heterogeneity factor

(HF), defined as the derivative (dV/dT) of a volume-threshold function for a

primary tumor. We measured the maximum standardized uptake value (SUVmax ) and

volumetric PET parameters. The relationship between HF and clinical parameters,

as well as other PET parameters, was evaluated. RESULTS: The HF was significantly

correlated with SUVmax (r = -0.353, P = 0.017), metabolic tumor volume (r =

-0.708, P < 0.0001), and total lesion glycolysis (r = -0.709, P < 0.0001). A

multivariate analysis revealed not only cervical lymph node metastasis (hazard

ratio = 5.983; P = 0.022) but also HF (hazard ratio = 2.49 x 10(-4) ; P = 0.002)

to be independent predictors of overall survival. Those patients with HF < -0.13

showed a worse prognosis than those with HF >/= -0.13 (P = 0.005). CONCLUSIONS:

The intratumoral heterogeneity of (18) F-FDG uptake may be a significant

prognostic factor for overall survival in addition to cervical lymph node

metastasis in oral cavity cancer. J. Surg. Oncol. 2014 110:702-706. (c) 2014

Wiley Periodicals, Inc.