Prognostic value of FDG-PET volumetric parameters in patients with p16-positive oropharyngeal squamous cell carcinoma who received curative resection followed by postoperative radiotherapy or chemoradiotherapy

Abstract

Background

The purpose of this study was to determine whether pretreatment 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) volumetric parameters add more prognostic information to p16-positive oropharyngeal squamous cell carcinoma (SCC).

Methods

We retrospectively analyzed 86 patients with p16-positive oropharyngeal SCC who underwent surgery and postoperative radiotherapy (RT) or chemoradiotherapy (CRT). Maximum standardized uptake value (SUV_max), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured.

Results

Higher total MTV (tMTV), nodal MTV (nMTV), and tumor TLG (tTLG) were significantly associated with lower disease-free survival (DFS) (all p < .05) and higher distant metastasis rates (all p < .05). Multivariate analysis of DFS revealed that tMTV (p = .032), nMTV (p = .004), and tTLG (p = .018) were independently significant prognosticators.

Conclusion

Patients with p16-positive disease with high metabolic tumor burden were associated with higher distant metastasis rates, translating into worse survival. These patients may not be optimal candidates for treatment deintensification. © 2016 Wiley Periodicals, Inc. Head Neck, 2016

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