Visceral adipose tissue volume and CT-attenuation as prognostic factors in patients with head and neck cancer.

Abstract

The aim of this study was to evaluate the relationship of the characteristics of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) to the disease progression-free survival and distant failure-free survival of head and neck squamous cell carcinoma (HNSCC). We enrolled 152 HNSCC patients who underwent staging ¹⁸ F-fluorodeoxyglucose (FDG) positron emission tomography/CT (PET/CT). Maximum FDG uptake (standardized uptake value [SUV]) and total lesion glycolysis (TLG) of the primary tumor and volume, CT-attenuation (Hounsfield units [HU]), and FDG uptake of SAT and VAT were measured. Survival analysis using Cox proportional hazard modeling was performed to assess the relationship between the adipose tissue parameters of PET/CT and survival. Patients with low VAT volume and high VAT HU had significantly worse progression-free survival and distant failure-free survival than those with high VAT volume and low VAT HU. On multivariate analysis, the volume and HU of VAT were significantly correlated with disease progression-free survival and distant failure-free survival after adjusting for age, sex, body mass index, TNM stage, serum C-reactive protein, maximum SUV, and TLG. The volume and CT-attenuation of VAT were significantly correlated with disease progression-free survival and distant failure-free survival in patients with HNSCC.