FDG PET/CT Parameters Yield Prognostic Value After Surgery for HNSCC

Study findings posit using fluorodeoxyglucose F 18–labeled positron emission tomography and computed tomography (FDG-PET/CT) parameters to identify patients with head and neck squamous cell cancer (HNSCC) and a higher risk for disease progression postsurgery who could benefit from early therapeutic intensification (JAMA Otolaryngol Head Neck Surg. 2020 Mar 26. Epub ahead of print).

“[HNSCC] represents the seventh most frequent cancer worldwide. More than half of the patients diagnosed with HNSCC are treated with primary surgery,” Gwenaelle Creff, MSc, Department of Otolaryngology–Head and Neck Surgery, Rennes University Hospital, Rennes, France, and colleagues explained.

Seeking to assess the value of quantitative FDG-PET/CT parameters performed presurgery for HNSCC to estimate overall survival (OS), disease-free survival (DFS), and distant metastasis (DM), Ms Creff et al conducted a systematic review.

Between March 1, 2019, and July 27, 2019, they reviewed PubMed/MEDLINE and ScienceDirect databases for articles published between January 2003 and February 2019 addressing the link between preoperative FDG-PET/CT parameters and oncologic outcomes in patients with HNSCC.

Overall, 128 studies were retrieved, and 36 studies met inclusion criteria for the analysis; these studies comprised a total of 3585 unique patients with a median follow-up of 30.6 months. A link between at least 1 FDG-PET/CT parameter and oncologic outcomes (OS, DFS, and DM) was observed in 32 of the 36 studies.

Notably, FDG-PET/CT volumetric parameters (metabolic tumor volume and total lesion glycolysis) were predictive factors in most of the data, with a higher prognostic value than the maximum standard uptake value.

Furthermore, Ms Creff and colleagues stated that spatial distribution of metabolism via textural indices seemed promising, although evidence of that factor is limited.

“The findings of this study suggest that the prognostic effectiveness of FDG-PET/CT parameters as biomarkers of OS, DFS, and DM among patients with HNSCC treated with surgery may be valuable,” the researchers concluded.—Hina Porcelli