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Prognostic value of pretreatment 18F-FDG PET/CT and human papillomavirus type 16 testing in locally advanced oropharyngeal squamous cell carcinoma

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Abstract

Purpose

Human papillomavirus type 16 (HPV-16) positivity is associated with favourable survival in oropharyngeal squamous cell carcinoma (OPSCC). We report here a study of the prognostic significance of 18F-FDG PET/CT functional parameters and HPV-16 infection in OPSCC patients.

Methods

We retrospectively analysed 60 patients with stage III or IV OPSCC who had had a pretherapy 18F-FDG PET/CT scan and had completed concurrent chemoradiotherapy (n = 58) or curative radiotherapy (n = 2). All patients were followed up for ≥24 months or until death. We determined total lesion glycolysis (TLG) and the maximal standardized uptake values (SUVmax) of the primary tumour and neck lymph nodes from the pretherapy 18F-FDG PET/CT scan. Optimal cut-offs of the 18F-FDG PET/CT parameters were obtained by receiver operating characteristic (ROC) curve analyses. Pretherapy tumour biopsies were studied by polymerase chain reaction to determine HPV infection status.

Results

The pretherapy tumour biopsies were positive for HPV-16 in 12 patients (20.0 %). Cox regression analyses revealed HPV-16 positivity and tumour TLG >135.3 g to be independently associated with overall survival (p = 0.027 and 0.011, respectively). However, only tumour TLG >135.3 g was independently associated with progression-free survival, disease-free survival and locoregional control (p = 0.011, 0.001 and 0.034, respectively). A scoring system was formulated to define distinct overall survival groups using tumour TLG and HPV-16 status. Patients positive for HPV-16 and with tumour TLG ≤135.3 g experienced better survival than those with tumour TLG >135.3 g and no HPV infection (p = 0.001).

Conclusion

Tumour TLG was an independent predictor of survival in patients with locally advanced OPSCC. A scoring system was developed and may serve as a risk stratification strategy for guiding therapy.

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Acknowledgments

This study was supported by CMRPG360072 and CMRPG360073 from Chang Gung University and Chang Gung Memorial Hospital, Taiwan.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan

    Nai-Ming Cheng & Tzu-Chen Yen

  2. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan

    Joseph Tung-Chieh Chang, Din-Li Tsan & Chien-Yu Lin

  3. Department of Laboratory Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taipei, Taiwan

    Chung-Guei Huang

  4. Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan

    Shu-Hang Ng

  5. Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan

    Hung-Ming Wang & Cheng-Lung Hsu

  6. Department of Otolaryngology–Head & Neck Surgery, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan

    Chun-Ta Liao

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  1. Nai-Ming Cheng
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Correspondence to Tzu-Chen Yen.

Additional information

Nai-Ming Cheng and Joseph Tung-Chieh Chang contributed equally to this work.

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Cutoffs of PET parameters (DOC 34 kb)

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Cheng, NM., Chang, J.TC., Huang, CG. et al. Prognostic value of pretreatment 18F-FDG PET/CT and human papillomavirus type 16 testing in locally advanced oropharyngeal squamous cell carcinoma. Eur J Nucl Med Mol Imaging 39, 1673–1684 (2012). https://doi.org/10.1007/s00259-012-2186-9

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