PT - JOURNAL ARTICLE AU - Sang Yoon Kim AU - Jong-Lyel Roh AU - Mi Ra Kim AU - Jae Seung Kim AU - Seung-Ho Choi AU - Soon Yuhl Nam AU - Sang-wook Lee AU - Sung-Bae Kim TI - Use of <sup>18</sup>F-FDG PET for Primary Treatment Strategy in Patients with Squamous Cell Carcinoma of the Oropharynx AID - 10.2967/jnumed.107.039610 DP - 2007 May 01 TA - Journal of Nuclear Medicine PG - 752--757 VI - 48 IP - 5 4099 - http://jnm.snmjournals.org/content/48/5/752.short 4100 - http://jnm.snmjournals.org/content/48/5/752.full SO - J Nucl Med2007 May 01; 48 AB - High tumor uptake of 18F-FDG is associated with an unfavorable outcome in cancer patients. We evaluated pretreatment 18F-FDG uptake as guidance for the primary treatment modality in patients with squamous cell carcinoma (SCC) of the oropharynx. Methods: Fifty-two consecutive patients with newly diagnosed resectable SCC of the oropharynx underwent 18F-FDG PET before treatment. Primary treatment modalities consisted of surgical resection plus radiotherapy (RT) (surgery group, n = 31) or radical RT plus chemotherapy (RT group, n = 21). The sex, age, tumor stage, histologic grade, TNM classification, treatment strategy, and maximum standardized uptake value (SUV) categories were analyzed for association with local control (LC) and disease-free survival (DFS). The median follow-up of the surviving patients was 36 mo. Results: The median SUV was significantly higher in the 11 patients who failed treatment than that in the remaining controlled patients (8.0 vs. 5.4; P = 0.021). Patients having tumors with a high SUV &gt; 6.0 had poorer LC and DFS (P &lt; 0.05). In multivariate analysis, the SUV remained an independent determinant of LC and DFS (P &lt; 0.05). Patients with a SUV &gt; 6.0 in the surgery group had a higher 3-y DFS than that in the RT group (78% vs. 33%; P = 0.043). Conclusion: Pretreatment tumor 18F-FDG uptake represents an independent prognostic factor in patients with oropharyngeal SCC. Patients with high 18F-FDG uptake may be better treated by surgery followed by RT with or without chemotherapy, which needs to be verified by a prospective randomized study.