Prognostic value of volume-based (18)F-fluorodeoxyglucose PET/CT parameters in patients with clinically node-negative oral tongue squamous cell carcinoma

Abstract

OBJECTIVE: To evaluate the prognostic value of volume-based metabolic parameters measured with (18)F-fluorodeoxyglucose ((18)F-FDG) positron emission tomography (PET) in patients with clinically node-negative (cN0) oral tongue squamous cell carcinoma (OTSCC) as compared with other prognostic factors.

MATERIALS AND METHODS: In this study, we included a total of 57 patients who had been diagnosed with cN0 tongue cancer by radiologic, (18)F-FDG PET/CT, and physical examinations. The maximum standardized uptake value (SUV(max)), average SUV (SUV(avg)), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) for primary tumors were measured with (18)F-FDG PET. The prognostic significances of these parameters and other clinical variables were assessed by Cox proportional hazards regression analysis.

RESULTS: In the univariate analysis, pathological node (pN) stage, American Joint Committee on Cancer (AJCC) stage, SUV(max), SUV(avg), MTV, and TLG were significant predictors for survival. On a multivariate analysis, pN stage (hazard ratio = 10.555, p = 0.049), AJCC stage (hazard ratio = 13.220, p = 0.045), and MTV (hazard ratio = 2.698, p = 0.033) were significant prognostic factors in cN0 OTSCC patients. The patients with MTV ≥ 7.78 cm(3) showed a worse prognosis than those with MTV < 7.78 cm(3) (p = 0.037).

CONCLUSION: The MTV of primary tumor as a volumetric parameter of (18)F-FDG PET, in addition to pN stage and AJCC stage, is an independent prognostic factor for survival in cN0 OTSCC.