Value of SUV<sub>max</sub> for the Prediction of Bone Invasion in Oral Squamous Cell Carcinoma
In advanced oral squamous cell carcinoma (OSCC), accurate planning of surgical resection and reconstruction are crucial for outcome and postoperative function. For OSCC close to the maxilla or mandible, prediction of bone invasion is necessary. The aim of this study was to examine whether metabolic...
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MDPI AG
2020-02-01
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| Online Access: | https://www.mdpi.com/2079-7737/9/2/23 |
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| author | Stephanie A. Stalder Paul Schumann Martin Lanzer Martin W. Hüllner Niels J. Rupp Martina A. Broglie Grégoire B. Morand |
| author_facet | Stephanie A. Stalder Paul Schumann Martin Lanzer Martin W. Hüllner Niels J. Rupp Martina A. Broglie Grégoire B. Morand |
| author_sort | Stephanie A. Stalder |
| collection | DOAJ |
| description | In advanced oral squamous cell carcinoma (OSCC), accurate planning of surgical resection and reconstruction are crucial for outcome and postoperative function. For OSCC close to the maxilla or mandible, prediction of bone invasion is necessary. The aim of this study was to examine whether metabolic tumor imaging obtained by fluorodeoxyglucose positron emission tomography (FDG-PET) could enhance preoperative predictability of bone invasion. We performed an analysis of 84 treatment-naïve OSCCs arising from gum (upper and lower), hard palate, floor of mouth, and retromolar trigone treated at the University Hospital Zurich, Switzerland, who underwent wide local excision with free flap reconstruction between 04/2010 and 09/2018 and with available preoperative FDG-PET. Prediction of bone invasion by metabolic tumor imaging such as maximum standardized uptake value (SUV<sub>max</sub>) was examined. On definitive histopathology, bone invasion was present in 47 of 84 cases (56%). The probability of bone infiltration increased with a higher pretherapeutic SUV<sub>max</sub> in an almost linear manner. A pretherapeutic SUV<sub>max</sub> of primary tumor below 9.5 ruled out bone invasion preoperatively with a high specificity (97.6%). The risk of bone invasion was 53.6% and 71.4% for patients with SUV<sub>max</sub> between 9.5−14.5 and above 14.5, respectively. Patients with bone invasion had worse distant metastasis-free survival compared to patients without bone invasion (log-rank test, <i>p</i> = 0.032). In conclusion, metabolic tumor imaging using FDG-PET could be used to rule out bone invasion in oral cancer patients and may serve in treatment planning. |
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| language | English |
| last_indexed | 2024-03-12T10:41:57Z |
| publishDate | 2020-02-01 |
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| spelling | doaj.art-b02a8e13a73847f0929a31e640217c382023-09-02T08:05:48ZengMDPI AGBiology2079-77372020-02-01922310.3390/biology9020023biology9020023Value of SUV<sub>max</sub> for the Prediction of Bone Invasion in Oral Squamous Cell CarcinomaStephanie A. Stalder0Paul Schumann1Martin Lanzer2Martin W. Hüllner3Niels J. Rupp4Martina A. Broglie5Grégoire B. Morand6Department of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, SwitzerlandFaculty of Medicine, University of Zurich, 8006 Zurich, SwitzerlandFaculty of Medicine, University of Zurich, 8006 Zurich, SwitzerlandFaculty of Medicine, University of Zurich, 8006 Zurich, SwitzerlandFaculty of Medicine, University of Zurich, 8006 Zurich, SwitzerlandDepartment of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, SwitzerlandDepartment of Otorhinolaryngology - Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, SwitzerlandIn advanced oral squamous cell carcinoma (OSCC), accurate planning of surgical resection and reconstruction are crucial for outcome and postoperative function. For OSCC close to the maxilla or mandible, prediction of bone invasion is necessary. The aim of this study was to examine whether metabolic tumor imaging obtained by fluorodeoxyglucose positron emission tomography (FDG-PET) could enhance preoperative predictability of bone invasion. We performed an analysis of 84 treatment-naïve OSCCs arising from gum (upper and lower), hard palate, floor of mouth, and retromolar trigone treated at the University Hospital Zurich, Switzerland, who underwent wide local excision with free flap reconstruction between 04/2010 and 09/2018 and with available preoperative FDG-PET. Prediction of bone invasion by metabolic tumor imaging such as maximum standardized uptake value (SUV<sub>max</sub>) was examined. On definitive histopathology, bone invasion was present in 47 of 84 cases (56%). The probability of bone infiltration increased with a higher pretherapeutic SUV<sub>max</sub> in an almost linear manner. A pretherapeutic SUV<sub>max</sub> of primary tumor below 9.5 ruled out bone invasion preoperatively with a high specificity (97.6%). The risk of bone invasion was 53.6% and 71.4% for patients with SUV<sub>max</sub> between 9.5−14.5 and above 14.5, respectively. Patients with bone invasion had worse distant metastasis-free survival compared to patients without bone invasion (log-rank test, <i>p</i> = 0.032). In conclusion, metabolic tumor imaging using FDG-PET could be used to rule out bone invasion in oral cancer patients and may serve in treatment planning.https://www.mdpi.com/2079-7737/9/2/23carcinomasquamous cellpositron emission tomographyfluorodeoxyglucose f18bonetumor hypoxia |
| spellingShingle | Stephanie A. Stalder Paul Schumann Martin Lanzer Martin W. Hüllner Niels J. Rupp Martina A. Broglie Grégoire B. Morand Value of SUV<sub>max</sub> for the Prediction of Bone Invasion in Oral Squamous Cell Carcinoma Biology carcinoma squamous cell positron emission tomography fluorodeoxyglucose f18 bone tumor hypoxia |
| title | Value of SUV<sub>max</sub> for the Prediction of Bone Invasion in Oral Squamous Cell Carcinoma |
| title_full | Value of SUV<sub>max</sub> for the Prediction of Bone Invasion in Oral Squamous Cell Carcinoma |
| title_fullStr | Value of SUV<sub>max</sub> for the Prediction of Bone Invasion in Oral Squamous Cell Carcinoma |
| title_full_unstemmed | Value of SUV<sub>max</sub> for the Prediction of Bone Invasion in Oral Squamous Cell Carcinoma |
| title_short | Value of SUV<sub>max</sub> for the Prediction of Bone Invasion in Oral Squamous Cell Carcinoma |
| title_sort | value of suv sub max sub for the prediction of bone invasion in oral squamous cell carcinoma |
| topic | carcinoma squamous cell positron emission tomography fluorodeoxyglucose f18 bone tumor hypoxia |
| url | https://www.mdpi.com/2079-7737/9/2/23 |
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