Study of Prognostic Prediction Using Pre-treatment PET/CT in Oral Cancer Patients
Kuniko Mizuta , Department of Oral and Maxillofacial Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Kouji Ohta DDS, PhD, Department of Oral and Maxillofacial Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Shinichi Fujimoto , Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Ryo Uetsuki , Department of Oral and Maxillofacial Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Masaaki Takechi DDS, PhD, Department of Oral and Maxillofacial Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
Statement of the problem: We performed a clinico-statistical study of patients with oral cancer that were taken positron emission tomography combined with computed tomography (PET/CT) as preoperative examination in the past eight years at our department. The aim of this retrospective study was to investigate relevance of prognosis and pre-treatment [
18F]-2-fluorodeoxyglucose (
18F-FDG) uptake of the primary tumor, assessed by PET/CT in oral cancer patients of our department. There has been already reported
that high FDG uptake is clinically correlated with shorter survival, lymph node metastasis, and poor response to such therapies as surgery and radiotherapy. We investigated whether maximum standardized uptake value (SUVmax) of primary site assessed by
18F-FDG-PET/CT is correlated with overall survival in patient with oral squamous cell carcinoma.
Patients and methods: Between from January 2006 to December 2013, 105 patients with oral squamous cell carcinoma who underwent 18F-FDG-PET/CT before treatment and performed initial treatment in our department.
Methods of data analysis: 18F-FDG uptake was quantitated as maximum standardized uptake value (SUVmax). Overall survival rate was estimated using the Kaplan-Meier method, and group comparisons were performed with the long-rank mean test and Chi-square test. P-values of less than 0.05 were regarded as statistically significant.
Results: The median SUVmax value of 98 cases, avoiding 7 cases which undetected abnormal uptake by FDG-PET, was 9.57 (range 2-32.9). The group with high uptake of FDG (SUVmax >13) significantly exhibited shorter overall survival rate than the group with low uptake of FDG (SUVmax<13).
Conclusions: High uptake of FDG by pre-treatment 18F-FDG-PET/CT assessment could be an important factor in predicting the prognosis of oral cancer patients.
References:
1. Suzuki H, Kato K, Fujimoto Y, Itoh Y, Hiramatsu M, Maruo T, Naganawa S, Hasegawa Y, Nakashima T: 18F-FDG-PET/CT predicts survival in hypopharyngeal squamous cell carcinoma. Ann Nucl Med 27: 297-302, 2013
2. Kikuchi M, Yamane T, Shinohara S, Fujiwara K, Hori SY, Tona Y, Yamazaki H, Naito Y, Senda M: 18F-fluoromisonidazole positron emission tomography before treatment is a predictor of radiotherapy outcome and survival prognosis in patients with head and neck squamous cell carcinoma. Ann Nucl Med 25: 625-633, 2011
