PROGNOSTIC SIGNIFICANCE OF HIGH FDG UPTAKES ON F18 FDG PET IN HEAD AND NECK CANCER : MULTIVARIATE AN

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PROGNOSTIC SIGNIFICANCE OF HIGH FDG UPTAKES ON
F-18 FDG PET IN HEAD AND NECK CANCER
MULTIVARIATE ANALYSISBC Lee,1 BI Kim,2 GJ
Cheon,2 CW Choi,2 YS Lee,1 SM Lim,2 SW Hong2
Departments of 1Head and Neck Surgery and
2Nuclear Medicine, Korea Institute Radiological
And Medical Sciences, Seoul, Korea
Introduction

• Then, we performed Cox regression test (by
  forwardlikelhood-ratio method) with same
  parameters. SUV as cut-off 8 is significant to
  prognosis at step 1, other step is not
  progressed.

• Up to date, known important prognostic factors
  of head and neck cancer are the stage at
  diagnosis, recurrence after treatment. But, we
  sometimes have experienced a patient who has low
  stage cancer has poor result because of
  progressive nature of tumor, or another patient
  who has advanced stage has cured due to mild
  nature of tumor. The stage at initial diagnosis
  is not enough to explain the result of the
  patient. We have to find out another prognostic
  factor.
• 18F FDG PET scan (PET) is useful tool of finding
  out concealed tumor or metastatic lesion. The
  same time, attenuation corrected standardized
  uptake value (SUV) of lesion is taken from PET
  scan. SUV represents the degree of glucose uptake
  of lesion and this is known to be related the
  degree of malignancy, growing velocity and
  biological nature of tumor. Previously, a report
  that SUV is related to prognosis of lung cancer
  is published, and we expect that SUV in head and
  neck cancer will be a valuable prognostic factor.

• Correlation of SUV with some variables was
  calculated.
• SUV is correlated with Stage.

Materials and Methods

• Thirty patients with head and neck cancer were
  performed 18F FDG PET before defined treatment.
• Male Female 255, mean age 65.
• Pathologic diagnosis were all squamous cell
  carcinoma
• Disease free survival time was determined by
  follow up study till 14 months after treatment.
• Maximal SUV of primary lesion on pretreatment PET
  was measured. Optimal cut-off value of SUV for
  disease free survival time was determined by
  log-rank test.
• To determine which has prognostic significance,
  SUV of primary lesion, age, tumor size, degree of
  differentiation, pretreatment stage, treatment
  method were analyzed by Cox regression test.
• The software used in this study was SPSS version
  11.

Comparison of disease free survival curve by SUV
(cut off 8)
( P0.015)
Conclusion
Results

• SUV is higher than 8, prognosis is poorer.
• SUV is related to stage of disease.
• SUV is possible prognostic factor in head and
  neck cancer.
• It is suspected that the tumor with high SUV at
  primary site is tend to grow more aggressively
  than low SUV tumor.
• When we met a patients with high SUV tumor, more
  close observation is necessary after treatment.

• The mean SUV was 7.5 , median SUV was 6.5
  (minimum 0.23, maximum 17.1).
• To find out optimum cut-off value of SUV, we
  repeated log-rank test. We found that when
  cut-off value is 8, prognosis is differed most
  remarkably(table 1).

Reference

• Then, we performed log-rank test for each
  parameters ( pathologic differentiation, tumor
  size, age, stage, treatment modality, and SUV as
  cut-off 8). SUV as cut-off 8 is only significant
  to prognosis (disease free survival), others are
  not significant.

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