PET/CT prior to salvage surgery in recurrent head and neck squamous cell carcinoma
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PET/CT prior to salvage surgery in recurrent head and neck squamous cell carcinoma. / Nøhr, A; Gram, S B; Charabi, B; Tvedskov, J F; Wessel, I; Friborg, J; Håkansson, K; von Buchwald, C; Fischer, B M; Rasmussen, Jacob H.
I: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, Bind 276, Nr. 10, 10.2019, s. 2895-2902.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - PET/CT prior to salvage surgery in recurrent head and neck squamous cell carcinoma
AU - Nøhr, A
AU - Gram, S B
AU - Charabi, B
AU - Tvedskov, J F
AU - Wessel, I
AU - Friborg, J
AU - Håkansson, K
AU - von Buchwald, C
AU - Fischer, B M
AU - Rasmussen, Jacob H
PY - 2019/10
Y1 - 2019/10
N2 - PURPOSE: The purpose of this study was to assess the use of 18F-FDG PET/CT scans for detecting distant metastases in patients with recurrent head and neck squamous cell carcinoma (HNSCC) and investigate the treatment and survival of patients with recurrence.METHODS: In this retrospective study, consecutive head and neck cancer patients referred for FDG PET/CT scan between 2012 and 2014 were included. Patient records were reviewed and only patients with recurrence of HNSCC were enrolled for further analysis. Information on distant metastases, surgery and survival was collected. A Kaplan-Meier analysis was used to report survival.RESULTS: Overall 275 PET/CT scans were performed due to suspected recurrence, and in 166 scans (144 patients), recurrence of HNSCC was confirmed, making them eligible for further analysis. Distant metastases were revealed in 29.8% of the scans (n = 51) and the proportion of revealed metastases remained constant at approximately 30% each year. Although the number of performed scans increased twofold each year, there was no statistically significant change in the proportion of scans with distant metastasis (p = 0.55). The distant metastases were most often seen in the lungs (n = 44) and bone (n = 15). A few patients had widespread dissemination to other areas. Salvage surgery was performed following 81 of the 166 PET/CT scans. Seven of the patients who underwent salvage surgery had M-site oligo-metastases. Patients who underwent salvage surgery had a median survival of 22 months whereas patients not treated with salvage surgery had a median survival of 6 months. After 5 years, 21% of the patients selected for salvage surgery were alive.CONCLUSIONS: Distant metastases occur frequently in patients with recurrent HNSCC disease and the proportion of revealed distant metastases remained the same (30%). Imaging with FDG PET/CT can be recommended in patients with recurrent HNSCC prior to putative salvage surgery.
AB - PURPOSE: The purpose of this study was to assess the use of 18F-FDG PET/CT scans for detecting distant metastases in patients with recurrent head and neck squamous cell carcinoma (HNSCC) and investigate the treatment and survival of patients with recurrence.METHODS: In this retrospective study, consecutive head and neck cancer patients referred for FDG PET/CT scan between 2012 and 2014 were included. Patient records were reviewed and only patients with recurrence of HNSCC were enrolled for further analysis. Information on distant metastases, surgery and survival was collected. A Kaplan-Meier analysis was used to report survival.RESULTS: Overall 275 PET/CT scans were performed due to suspected recurrence, and in 166 scans (144 patients), recurrence of HNSCC was confirmed, making them eligible for further analysis. Distant metastases were revealed in 29.8% of the scans (n = 51) and the proportion of revealed metastases remained constant at approximately 30% each year. Although the number of performed scans increased twofold each year, there was no statistically significant change in the proportion of scans with distant metastasis (p = 0.55). The distant metastases were most often seen in the lungs (n = 44) and bone (n = 15). A few patients had widespread dissemination to other areas. Salvage surgery was performed following 81 of the 166 PET/CT scans. Seven of the patients who underwent salvage surgery had M-site oligo-metastases. Patients who underwent salvage surgery had a median survival of 22 months whereas patients not treated with salvage surgery had a median survival of 6 months. After 5 years, 21% of the patients selected for salvage surgery were alive.CONCLUSIONS: Distant metastases occur frequently in patients with recurrent HNSCC disease and the proportion of revealed distant metastases remained the same (30%). Imaging with FDG PET/CT can be recommended in patients with recurrent HNSCC prior to putative salvage surgery.
KW - Antineoplastic Protocols
KW - Bone Neoplasms/diagnosis
KW - Denmark/epidemiology
KW - Female
KW - Fluorodeoxyglucose F18/pharmacology
KW - Head and Neck Neoplasms/mortality
KW - Humans
KW - Lung Neoplasms/diagnosis
KW - Male
KW - Middle Aged
KW - Neoplasm Recurrence, Local/pathology
KW - Positron Emission Tomography Computed Tomography/methods
KW - Radiopharmaceuticals/pharmacology
KW - Retrospective Studies
KW - Salvage Therapy/methods
KW - Squamous Cell Carcinoma of Head and Neck/mortality
KW - Survival Analysis
U2 - 10.1007/s00405-019-05550-1
DO - 10.1007/s00405-019-05550-1
M3 - Journal article
C2 - 31297609
VL - 276
SP - 2895
EP - 2902
JO - Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde
JF - Archiv fur klinische und experimentelle Ohren- Nasen- und Kehlkopfheilkunde
SN - 0942-8992
IS - 10
ER -
ID: 236987619