Metabolic tumor volume and total lesion glycolysis predict tumor progression and survival after salvage surgery for recurrent oral cavity squamous cell carcinoma.

Background: This study evaluated the prognostic role of Fluorine 18-fluorodeoxyglucose positron emission tomography/CT (18 F-FDG PET/CT) parameters quantitatively measured in patients with recurrent oral cavity cancer.

Methods: Cox proportional hazards regression analyses were used to assess the associations between quantitative 18 F-FDG PET/CT parameters and other clinicopathological factors and progression-free survival (PFS) and overall survival (OS).

Results: All of the 18 F-FDG PET parameters (SUVmax , SUVmean , SUVpeak , metabolic tumor volume [MTV], and total lesion glycolysis [TLG]) were significantly associated with poor PFS and OS outcomes after salvage treatment (P < .01). In multivariate analyses, Karnofsky performance score, recurrence site, MTV, and TLG were independent variables predictive of both PFS and OS (P < .05). High MTV (>8.8 mL) or TLG (>29.4 g) values at recurrent lesions were associated with >5-fold increased risk for tumor progression and mortality after salvage surgery.

Conclusions: The PET parameters of MTV and TLG measured at recurrent lesions may predict tumor progression and survival after salvage treatment. Condensed abstract: This study examined the role of 18 F-FDG PET/CT at recurrent staging for predicting tumor progression and survival in 71 consecutive patients with recurrent oral cavity squamous cell carcinomas. Of 18 F-FDG parameters, metabolic tumor volume and total lesion glycolysis were independent factors predictive of tumor progression and survival after salvage treatment.