Abdelhafez, Y., Moustafa, H. (2011). Pretreatment SUV of the metastatic neck lymph nodes predicts neck control and survival in patients with stage IV oro/hypopharyngeal cancers. test, 4(4), 27-36. doi: 10.21608/egyjnm.2011.5488
Yasser Gaber Abdelhafez; Hosna Moustafa. "Pretreatment SUV of the metastatic neck lymph nodes predicts neck control and survival in patients with stage IV oro/hypopharyngeal cancers". test, 4, 4, 2011, 27-36. doi: 10.21608/egyjnm.2011.5488
Abdelhafez, Y., Moustafa, H. (2011). 'Pretreatment SUV of the metastatic neck lymph nodes predicts neck control and survival in patients with stage IV oro/hypopharyngeal cancers', test, 4(4), pp. 27-36. doi: 10.21608/egyjnm.2011.5488
Abdelhafez, Y., Moustafa, H. Pretreatment SUV of the metastatic neck lymph nodes predicts neck control and survival in patients with stage IV oro/hypopharyngeal cancers. test, 2011; 4(4): 27-36. doi: 10.21608/egyjnm.2011.5488

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

Egyptian Journal Nuclear Medicine
Article 4, Volume 4, Issue 4, December 2011, Pages 27-36    PDF (384.05 K)
Document Type: Original Paper, Oncology
DOI: 10.21608/egyjnm.2011.5488
Authors
Yasser Gaber Abdelhafez* 1; Hosna Moustafa2
1Nuclear Medicine Unit, South Egypt Cancer Institute, Assuit University.
2Oncology and Nuclear Medicine Department, Kasr Al-Aini Hospital, Cairo University, Egypt.
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.

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