Open AccessDefining risk groups of patients with cancer of unknown primary site and cervical nodal metastases by F‐18 fluorodeoxyglucose positron emission tomography and computed tomography imaging
Author(s) -
Su YungYueh,
Chen ShihShin,
Hsieh ChiaHsun,
Liao ChunTa,
Lin ChienYu,
Kang ChungJan,
Yen TzuChen
Publication year - 2016
Publication title -
the kaohsiung journal of medical sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.439
H-Index - 36
eISSN - 2410-8650
pISSN - 1607-551X
DOI - 10.1016/j.kjms.2016.07.004
Subject(s) - medicine , positron emission tomography , cervical cancer , confidence interval , nuclear medicine , standardized uptake value , univariate analysis , fluorodeoxyglucose , radiology , positron emission tomography computed tomography , multivariate analysis , cancer
We sought to investigate the clinical utility of F‐18 fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) in Taiwanese patients with cancer of unknown primary site (CUP) and cervical nodal metastases. We also aimed to study the impact of F‐18 FDG PET/CT on clinical treatment priority in this patient group. Between September 2006 and May 2014, patients with CUP and cervical nodal metastases who underwent F‐18 FDG PET/CT imaging study were retrospectively identified. The clinicopathological risk factors and PET parameters were analyzed in relation to 2‐year overall survival (OS) rates using univariate and multivariate analyses. Two‐year OS curves were plotted with the Kaplan–Meier method. Of the eligible patients ( n = 54), 12 (22.2%) had distant metastases (DM) at presentation. A total of 13 (24.1%) and 15 (27.8%) primary tumors were identified by FDG PET/CT imaging and an additional triple biopsy, respectively. The results of multivariate analysis identified smoking [ p = 0.033, 95% confidence interval (CI) = 1.197−40.342], a maximum standardized uptake value (SUV max ) of cervical nodes ≥ 14.2 ( p = 0.035, 95% CI = 1.134−28.029), and DM at presentation ( p = 0.031, 95% CI = 1.257−114.854) as independent predictors of 2‐year OS. Specifically, patients who carried ≥ 2 risk factors showed poorer outcomes (70.3% vs. 11.8%, p < 0.001). Fifteen study patients (27.8%) had their treatment modified by FDG PET/CT findings. We conclude that FDG PET/CT is clinically useful in CUP patients not only for tumor staging, but also for modifying treatment regimens.