Abstract
1089
Introduction: We evaluated prognostic roles of baseline F-18 FDG PET/CT in patients with nonmetastatic HPV-positive oropharyngeal cancer squamous cell carcinoma.
Methods: We retrospectively reviewed patients who diagnosed with stage I, II and III HPV-positive oropharyngeal squamous cell carcinoma in Severance Hospital from 2010 to 2015, who performed baseline F-18 FDG PET/CT. Patient who had a history of other malignancy were excluded. Mean SUV of the normal liver, and maximum SUV, metabolic tumor volume (MTV), total lesion glycolysis (TLG), and coefficient of variation (CV) of the primary tumor were measured. SUV was normalized using mean liver SUV. Patients were treated with curative resection and/or chemoradiation. End points were progression-free survival (PFS) and overall survival (OS).
Results: A total of 90 patients (male, 72; female, 18) were enrolled. Patients were followed up for 60.5 ± 21.2 (mean ± SD) months. During follow-up period, 15 patients were progressed, and 13 died. In univariate analysis, patients with higher overall stage (III vs I-II), tumor stage (T4 vs T1-T3), tumor to liver SUV ratio (TLR), MTV, TLG, and CV, and patient who received chemoradiation, as compared to who underwent surgery with/without chemoradiation, were associated with poorer PFS and OS. Multivariate analysis revealed that patients with advanced overall stage, and higher TLR or CV had poorer PFS and OS. Conclusion: We showed that TLR and CV of the primary tumor on baseline F-18 FDG PET/CT were associated with poorer PFS and OS in patients with nonmetastatic HPV-positive oropharyngeal squamous cell carcinoma. Further study is needed to address possible implications of F-18 FDG PET/CT in deciding treatment intensification or deintensification in these patients.