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Prognostic significance of the intratumoral heterogeneity of 18 F‐FDG uptake in oral cavity cancer
Author(s) -
Kwon Soo Hyun,
Yoon JoonKee,
An YoungSil,
Shin Yoo Seob,
Kim ChulHo,
Lee Dong Hyun,
Jo Kyung Sook,
Lee Su Jin
Publication year - 2014
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23703
Subject(s) - medicine , standardized uptake value , hazard ratio , nuclear medicine , lymph node , cancer , metastasis , cervical cancer , positron emission tomography , oncology , confidence interval
Backgrounds We evaluated the prognostic value of the intratumoral heterogeneity of 18 F‐FDG uptake in oral cavity cancer. Materials and Methods We enrolled 45 patients who underwent pretreatment 18 F‐FDG PET/CT. The intratumoral heterogeneity of 18 F‐FDG uptake was represented as the heterogeneity factor (HF), defined as the derivative (dV/dT) of a volume‐threshold function for a primary tumor. We measured the maximum standardized uptake value (SUV max ) and volumetric PET parameters. The relationship between HF and clinical parameters, as well as other PET parameters, was evaluated. Results The HF was significantly correlated with SUV max (r = −0.353, P = 0.017), metabolic tumor volume (r = −0.708, P < 0.0001), and total lesion glycolysis (r = −0.709, P < 0.0001). A multivariate analysis revealed not only cervical lymph node metastasis (hazard ratio = 5.983; P = 0.022) but also HF (hazard ratio = 2.49 × 10 −4 ; P = 0.002) to be independent predictors of overall survival. Those patients with HF < −0.13 showed a worse prognosis than those with HF ≥ −0.13 ( P = 0.005). Conclusions The intratumoral heterogeneity of 18 F‐FDG uptake may be a significant prognostic factor for overall survival in addition to cervical lymph node metastasis in oral cavity cancer. J. Surg. Oncol. 2014 110:702–706 . © 2014 Wiley Periodicals, Inc.