Prognostic role of primary tumor metabolic-volumetric parameters of 18F-fluorodeoxyglucose positron emission tomography in tongue squamous cell carcinoma

Year 2023, , 183 - 189, 12.01.2023

Uğuray Aydos , Süleyman Cebeci

https://doi.org/10.32322/jhsm.1220117

Abstract

Aim: It was aimed to evaluate the prognostic role of primary tumor metabolic-volumetric parameters of 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) in resectable tongue squamous cell carcinoma (TSCC).
Material and Method: The imaging findings of 44 TSCC patients (23 females, 21 males, mean age: 58±12 years) with resectable tumors who underwent 18F-FDG PET/CT imaging for primary staging before surgery between 2010-2021 were evaluated retrospectively. Maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG), metabolic tumor volume (MTV) of primary tumors were acquired from PET/CT. Histopathological risk factors (pathological tumor and nodal stage, perineural and lymphovascular invasion, depth of invasion, surgical margin positivity) obtained from surgical resection material of primary tumors were also recorded. The prognostic values of imaging and histopathological parameters were assessed by Cox proportional hazards regression models. Survival curves were estimated by using the Kaplan-Meier analysis.
Results: The median follow-up period after diagnosis was 24 months (range: 2-152 months). The univariate and multivariate regression analyses demonstrated that MTV was the only parameter which was significantly related to prognosis for PFS and OS. The patients with higher MTV (> 3.13 cm3) had lower PFS and OS rates compared to those with lower MTV (≤ 3.13 cm3) (p<0.001, p=0.002, respectively).
Conclusion: Primary tumor MTV is an independent prognostic factor in resectable TSCC. PET volumetric features can be used as prognostic biomarker to predict patients with poor prognosis.

Keywords

FDG, metabolic tumor volume, PET/CT, survival, tongue squamous cell carcinoma

References

• Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019; 69: 7-34.
• da Silva Souto AC, Vieira Heimlich F, Lima de Oliveira L, et al. Epidemiology of tongue squamous cell carcinoma: A retrospective cohort study. Oral Dis 2021; 00: 1-9.
• Moore S, Johnson N, Pierce A, Wilson D. The epidemiology of tongue cancer: a review of global incidence. Oral Dis 2000; 6: 75-84.
• Li Y, Zhao Z, Liu X, et al. Nomograms to estimate long‐term overall survival and tongue cancer‐specific survival of patients with tongue squamous cell carcinoma. Cancer Med 2017; 6: 1002-13.
• Chang B, He W, Ouyang H, et al. A prognostic nomogram incorporating depth of tumor invasion to predict long-term overall survival for tongue squamous cell carcinoma with R0 resection. J Cancer 2018; 9: 2107-15.
• Huang S, Zhu Y, Cai H, Zhang Y, Hou J. Impact of lymphovascular invasion in oral squamous cell carcinoma: A meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131: 319-28. e1.
• Li J, Liu S, Li Z, Han X, Que L. Prognostic value of perineural invasion in oral tongue squamous cell carcinoma: a systematic review and meta-analysis. Front Oncol 2021; 11: 683825
• Binahmed A, Nason RW, Abdoh AA. The clinical significance of the positive surgical margin in oral cancer. Oral Oncol 2007; 43: 780-4.
• Colonia-García A, Salazar-Peláez LM, Serna-Ortiz CA, Álvarez-Sánchez LG, de Andrade CR. Prognostic value of lymphovascular and perineural invasion in squamous cell carcinoma of the tongue. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133: 207-15.
• Pfister DG, Spencer S, Adelstein D, et al. Head and neck cancers, version 2.2020, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 2020; 18: 873-98.
• Paleri V, Urbano T, Mehanna H, et al. Management of neck metastases in head and neck cancer: United Kingdom National Multidisciplinary Guidelines. J Laryngol Otol 2016; 130: S161-S9.
• Yi X, Fan M, Liu Y, Zhang H, Liu S. 18 FDG PET and PET‐CT for the detection of bone metastases in patients with head and neck cancer. A meta‐analysis. J Med Imaging Radiat Oncol 2013; 57: 674-9.
• Rohde M, Nielsen AL, Johansen J, et al. Head-to-head comparison of chest x-ray/head and neck MRI, chest CT/head and neck MRI, and 18F-FDG PET/CT for detection of distant metastases and synchronous cancer in oral, pharyngeal, and laryngeal cancer. J Nucl Med 2017; 58: 1919-24.
• Lee SJ, Choi JY, Lee HJ, et al. Prognostic value of volume-based 18F-fluorodeoxyglucose PET/CT parameters in patients with clinically node-negative oral tongue squamous cell carcinoma. Korean J Radiol 2012; 13: 752-9.
• Yonezawa N, Minamikawa T, Kitajima K, et al. The maximum standardized uptake value increment calculated by dual-time-point 18F-fluorodeoxyglucose positron emission tomography predicts survival in patients with oral tongue squamous cell carcinoma. Nagoya J Med Sci 2017; 79: 189-98.
• Lin N-C, Hsu J-T, Chen MY, Tsai K-Y. Maximum standardised uptake value is prognostic in patients with early-stage squamous cell carcinoma of the tongue. Br J Oral Maxillofac Surg 2022; 60: 1209-15.
• Suzuki-Shibata S, Yamamoto Y, Yoshida T, et al. Prognostic value of volumetric FDG PET/CT parameters in patients with oral tongue squamous cell carcinoma who were treated by superselective intra-arterial chemoradiotherapy. Jpn J Radiol 2017; 35: 740-7.
• Zanoni DK, Patel SG, Shah JP. Changes in the 8th edition of the American Joint Committee on Cancer (AJCC) staging of head and neck cancer: rationale and implications. Curr Oncol Rep 2019; 21: 52.
• Ho AS, Kim S, Tighiouart M, et al. Metastatic lymph node burden and survival in oral cavity cancer. J Clin Oncol 2017; 35: 3601-9.
• Suresh GM, Koppad R, Prakash B, Sabitha K, Dhara P. Prognostic indicators of oral squamous cell carcinoma. Ann Maxillofac Surg 2019; 9: 364-70.
• Kang C-J, Wen Y-W, Lee S-R, et al. Surgical Margins Status and Prognosis after Resection of Oral Cavity Squamous Cell Carcinoma: Results from a Taiwanese Nationwide Registry-Based Study. Cancers 2021; 14: 15.