Predictive Value of Occult Metastasis and Survival Significance of Metabolic Tumor Volume Determined by PET-CT in cT1-2N0 Squamous Cell Carcinoma of the Tongue

Abstract

ObjectivesOur goal was to analyze the possibility of using metabolic tumor volume (MTV) to predict occult cervical metastasis and survival in cT1-2N0 squamous cell carcinoma (SCC) of the tongue.MethodsData on the primary tumor MTV and cervical node status as determined by the maximum standardized uptake value were retrieved. The sensitivity and specificity in predicting occult metastasis were calculated with a fourfold table. Associations between occult metastasis and clinicopathological variables were evaluated by univariate and multivariate analyses. The main study endpoints were locoregional control (LRC) and disease-specific survival (DSS).ResultsA total of 24 (20.3%) of 118 patients had occult metastasis. An MTV cutoff value of 4.3 cm3 showed a sensitivity of 50.0% and a specificity of 76.6% in predicting occult metastasis. The sensitivity and specificity of PET-CT in predicting occult metastasis in cT1 tumors were 66.6 and 89.8%, respectively, with values of 83.3 and 67.3%, respectively, when combined with the MTV. The sensitivity and specificity of PET-CT in predicting occult metastasis in cT2 tumors were 72.2 and 82.2%, respectively, with values of 88.9 and 57.8%, respectively, when combined with the MTV. Patients with MTV ≥4.3 cm3 had a higher occult metastasis rate than patients with MTV <4.3 cm3. The 5-year LRC and DSS rates were 86 and 94%, respectively, in patients with MTV <4.3 cm3 and 54 and 72%, respectively, in patients with MTV ≥4.3 cm3. Both differences were found to be significant in univariate and multivariate analyses.ConclusionsMTV ≥4.3 cm3 was associated with an increased probability of occult metastasis and lower LRC and DSS rates in early-stage SCC of the tongue.

Positron Emission Tomography-Computed Tomography Parameters Predict Efficacy of Immunotherapy in Head and Neck Squamous Cell Carcinomas

“…High total MTV means a more advanced HNSCC, which is likely to have PD-L1 overexpression (20). Negative prognostic effect of MTV on surgically treated HNSCC has been extensively reported (11), with greater MTV usually related to increased possibility of lymph node metastasis, higher tumor stage, worse disease control and poor prognosis; our study noted after immunotherapy that there was no significant difference regarding PFS between patients with different total MTVs. This indicates the reliability of total MTV in predicting immunotherapy efficacy.…”

“…MTV was a commonly analyzed parameter of PET-CT; it referred to the volume of tumor tissue with high metabolic activity. Our previous studies have confirmed its negative effect on disease prognosis in HNSCC ( 11 ), but whether it is associated with the efficacy of immunotherapy in HNSCC remains unknown. We were the first to find that tumors with greater total MTV have better ORR than those with smaller total MTV, and that the improved treatment response contributed to similar PFS rates in the two groups; the finding was very interesting, on the one hand, usually the MTV reflected the tumor burden, it took length diameter and depth of invasion into consideration.…”

“…PET-CT is widely used for detecting disease metastasis in clinical practice, and its parameters including maximum standard uptake value (SUVmax) and metabolic tumor volume (MTV), are significantly associated with patient survival in HNSCC ( 10 , 11 ).…”

High-Resolution 18F-FDG PET/CT for Assessing Three-Dimensional Intraoperative Margins Status in Malignancies of the Head and Neck, a Proof-of-Concept

“…These results could indicate an important difference in peri-tumoral 18 F-FDG uptake, dependent on the tumor type, origin and location. Further research on the correlation between the uptake of 18 F-FDG uptake and its corresponding histology will increase our understanding of (peri-)tumoral 18 F-FDG distribution, and could hence help in correctly identifying and staging malignancies in head and neck and the thyroid on clinical PET/CT [25,26].…”

RFC4 promotes the progression and growth of Oral Tongue squamous cell carcinoma in vivo and vitro

“…And the surgical excision was still the mainstream treatment for lots of patients 2 . However, whether elective neck dissection (END) should be included in the treatment of early‐stage lesions (cT1‐2N0) of the tongue remained controversial 3 . There were many factors caused the occurrence and progression of oral tongue squamous cell carcinoma 4 ; many patients lost the timing of treatment in that they were diagnosed as late stage 5 .…”