Prognostic Value of ¹⁸ F-Fluoro-Deoxyglucose-Positron Emission Tomography Volumetric Parameters in Human Papillomavirus-Related Oropharyngeal Squamous Cell Carcinoma.

Abstract

This study evaluates and compares the prognostic significance of ¹⁸ F-fluoro-deoxyglucose-positron emission tomography (¹⁸ F-FDG PET) volumetric parameters in human papillomavirus-related oropharyngeal squamous cell carcinoma (OPSCC). A retrospective review of all patients treated for OPSCC with curative intent between 2012 and 2018 was performed. Volumetric parameters analyzed included the maximum standardized uptake value (SUV_max ), SUV_peak , metabolic tumor volume (MTV), and total lesion glycolysis (TLG) in both the primary tumor and nodal metastases. Prognostic significance was determined using Cox proportional hazards models for disease-free survival (DFS) and overall survival (OS). Primary tumor MTV and TLG significantly correlated with both DFS and OS however the commonly reported SUV_max was not found to be predictive. Nodal measures of SUV_max , MTV, and TLG were not significant predictors of survival outcomes. A higher burden of metabolically active primary tumor as measured on volumetric ¹⁸ F-FDG PET parameters is associated with poorer DFS and OS. This improved prognostication may be used to counsel patients and select those appropriate for treatment de-escalation in the future. 3 Laryngoscope, 133:1667-1672, 2023.