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Outcomes and Predictive Value of Post-adjuvant Therapy PET/CT for Locally Advanced Oral Squamous Cell Carcinoma.

Publication ,  Journal Article
Qian, DC; Magliocca, KR; Aiken, AH; Baugnon, KL; Brandon, DC; Stokes, WA; McDonald, MW; Patel, MR; Baddour, HM; Kaka, AS; Steuer, CE; Saba, NF ...
Published in: Laryngoscope
December 2020

OBJECTIVES/HYPOTHESIS: For locally advanced oral squamous cell carcinoma (OSCC) treated by surgery and adjuvant therapy, consensus has yet to be reached on whether the optimal time to initiate surveillance positron emission tomography/computed tomography (PET/CT) scan is before or after adjuvant therapy. In this study, we characterize the utility of PET/CT scans obtained 3 months after adjuvant therapy. STUDY DESIGN: PET/CT scans were obtained for 220 patients with stage III, IVA, or IVB OSCC who underwent resection followed by adjuvant radiotherapy or chemoradiotherapy. METHODS: Using the Neck Imaging Reporting and Data System, PET/CT scans were dichotomized as suspicious (primary or neck category ≥3, or distant lesion present) versus nonsuspicious. We then computed differences in locoregional progression, distant progression, and overall survival; positive predictive value (PPV), negative predictive value (NPV), sensitivity, and specificity; and success rate of salvage. RESULTS: Sixty-seven patients (30%) had suspicious PET/CT scans, which were significantly associated with local failure (hazard ratio [HR] 14.0, 95% confidence interval [CI] 7.3-26.6), distant failure (HR 18.4, 95% CI 9.6-35.3), and poorer overall survival (HR 9.5, 95% CI 5.0-17.9). Overall PPV, locoregional PPV, NPV, sensitivity, and specificity were 85%, 79%, 73%, 58%, and 92%, respectively. Among those with biopsy-confirmed progression, 37 patients (65%) underwent salvage therapy; four (11%) were without evidence of disease at last follow-up. CONCLUSIONS: For locally advanced OSCC, PET/CT scan 3 months after adjuvant therapy is strongly predictive of disease recurrence and survival, demonstrating improved performance over postoperative imaging in previous studies. Following a suspicious post-adjuvant therapy PET/CT scan, cure of locoregional recurrence is possible but unlikely. LEVEL OF EVIDENCE: 4 Laryngoscope, 2020.

Duke Scholars

Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

December 2020

Volume

130

Issue

12

Start / End Page

E850 / E857

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Radiotherapy, Adjuvant
  • Predictive Value of Tests
  • Positron Emission Tomography Computed Tomography
  • Otorhinolaryngology
  • Neoplasm Staging
  • Mouth Neoplasms
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Qian, D. C., Magliocca, K. R., Aiken, A. H., Baugnon, K. L., Brandon, D. C., Stokes, W. A., … Beitler, J. J. (2020). Outcomes and Predictive Value of Post-adjuvant Therapy PET/CT for Locally Advanced Oral Squamous Cell Carcinoma. Laryngoscope, 130(12), E850–E857. https://doi.org/10.1002/lary.28509
Qian, David C., Kelly R. Magliocca, Ashley H. Aiken, Kristen L. Baugnon, David C. Brandon, William A. Stokes, Mark W. McDonald, et al. “Outcomes and Predictive Value of Post-adjuvant Therapy PET/CT for Locally Advanced Oral Squamous Cell Carcinoma.Laryngoscope 130, no. 12 (December 2020): E850–57. https://doi.org/10.1002/lary.28509.
Qian DC, Magliocca KR, Aiken AH, Baugnon KL, Brandon DC, Stokes WA, et al. Outcomes and Predictive Value of Post-adjuvant Therapy PET/CT for Locally Advanced Oral Squamous Cell Carcinoma. Laryngoscope. 2020 Dec;130(12):E850–7.
Qian, David C., et al. “Outcomes and Predictive Value of Post-adjuvant Therapy PET/CT for Locally Advanced Oral Squamous Cell Carcinoma.Laryngoscope, vol. 130, no. 12, Dec. 2020, pp. E850–57. Pubmed, doi:10.1002/lary.28509.
Qian DC, Magliocca KR, Aiken AH, Baugnon KL, Brandon DC, Stokes WA, McDonald MW, Patel MR, Baddour HM, Kaka AS, Steuer CE, Saba NF, Shin DM, Beitler JJ. Outcomes and Predictive Value of Post-adjuvant Therapy PET/CT for Locally Advanced Oral Squamous Cell Carcinoma. Laryngoscope. 2020 Dec;130(12):E850–E857.
Journal cover image

Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

December 2020

Volume

130

Issue

12

Start / End Page

E850 / E857

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Radiotherapy, Adjuvant
  • Predictive Value of Tests
  • Positron Emission Tomography Computed Tomography
  • Otorhinolaryngology
  • Neoplasm Staging
  • Mouth Neoplasms
  • Middle Aged
  • Male