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Pretreatment SUV of the metastatic neck lymph nodes predicts neck control and survival in patients with stage IV oro/hypopharyngeal cancers

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Last updated: 03 Jan 2025

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Abstract

Purpose To investigate the prognostic significance of standardized uptake value (SUV) of metastatic neck lymph nodes measured on FDG PET/CT in patients with stage IV oro/hypopharyngeal cancers treated by definitive chemoradiotherapy (CCRT).
Methods Retrospective analysis of 65 patients with clinically N+ stage IV SCC of the oro/hypopharyngeal squamous cell carcinoma (SCC) who underwent FDG PET/CT scans for primary staging. Follow-up continued till death or at least 24 months from the start of treatment. The primary study endpoint was neck control (NC). The log-rank test and Cox proportional hazard analysis were used to identify significant prognostic factors.
Results The 3-year NC rate was 53%. In univariate analysis, N3 status and nodal SUV ≥ 9.8 were significantly associated with reduced NC. In multivariable analyses, nodal SUV retained its independent prognostic significance as a predictor of NC. Lymph node stage was an independent predictor of disease specific survival (DSS). A prognostic scoring system was constructed as follows: score 0 = N0-N2 and nodal SUV < 9.8; score 1 = N3 or nodal SUV ≥ 9.8; and score 2 = N3 and nodal SUV ≥ 9.8. Patients with a score of 2 showed the worst NC (hazard ratio [HR], 95% confidence interval [CI] = 10.5, 3.3-33.1; P < 0.001) and the lowest DSS (HR, 95% CI = 6.4, 2.2-18.7; P = 0.001).
Conclusion The combination of high nodal SUV and N3 neck disease identifies a subgroup of high-risk stage IV oro/hypopharyngeal SCC patients. Further prospective studies are warranted to validate this finding.

DOI

10.21608/egyjnm.2011.5488

Keywords

Neck lymph nodes ٠ FDG PET SUV ٠, Hypopharynx ٠ Oropharynx ٠ Prognosis ٠, Concomitant chemoradiotherapy

Authors

First Name

Yasser

Last Name

Abdelhafez

MiddleName

Gaber

Affiliation

Nuclear Medicine Unit, South Egypt Cancer Institute, Assuit University.

Email

yga1979@gmail.com

City

-

Orcid

0000-0002-1989-3094

First Name

Hosna

Last Name

Moustafa

MiddleName

-

Affiliation

Oncology and Nuclear Medicine Department, Kasr Al-Aini Hospital, Cairo University, Egypt.

Email

drhosna1947@gmail.com

City

-

Orcid

-

Volume

4

Article Issue

4

Related Issue

579

Issue Date

2011-12-01

Receive Date

2018-02-21

Publish Date

2011-12-01

Page Start

27

Page End

36

Print ISSN

1687-4994

Online ISSN

2536-9113

Article File

EGYJNM_Volume 4_Issue 4_Pages 27-36.pdf

PDF . 393.3kB

Link

https://egyjnm.journals.ekb.eg/article_5488.html

Detail API

https://egyjnm.journals.ekb.eg/service?article_code=5488

Order

4

Type

Original Paper, Oncology

Type Code

380

Publication Type

Journal

Publication Title

Egyptian Journal Nuclear Medicine

Publication Link

https://egyjnm.journals.ekb.eg/

MainTitle

Pretreatment SUV of the metastatic neck lymph nodes predicts neck control and survival in patients with stage IV oro/hypopharyngeal cancers

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Article

Created At

22 Jan 2023