Prognostic prediction using maximum standardized uptake value ratio of lymph node-to-primary tumor in preoperative PET-CT for oral squamous cell carcinoma

J Stomatol Oral Maxillofac Surg. 2023 Oct;124(5):101489. doi: 10.1016/j.jormas.2023.101489. Epub 2023 May 4.

Abstract

This study aimed to calculate the ratio of maximum standardized uptake values of cervical lymph nodes to maximum standardized uptake values of primary tumors measured by preoperative fluorodeoxyglucose positron-emission tomography in oral cancer patients, and to retrospectively examine the prognostic association and evaluate whether it could be a prognostic factor. We retrospectively examined consecutive Japanese patients diagnosed with oral squamous cell carcinoma who underwent oral cancer resection and cervical dissection between January 2014 and December 2018. The study included 52 patients aged 39-89 years (median age 66.5 years), excluding non-cervical dissection surgery and/or non-underwent preoperative positron-emission tomography. The maximum standardized uptake value of the cervical lymph nodes and primary tumor was measured, and the ratio of maximum standardized uptake values of the lymph nodes to that of the primary tumor was calculated. The median follow-up of 52 patients was 1,465 days (198-2,553 days), and overall survival was significantly worse in patients with a high lymph node-to-tumor standardized uptake values ratio (>0.4739) (5 years, 58.8% vs. 88.2%; P<0.05). Pretreatment lymph node-to-tumor standardized uptake values ratio can be easily calculated, and as a predictor of prognosis, it may be of assistance when considering the treatment strategy for oral cancer.

Keywords: Cervical lymph node; NTR; Oral squamous cell carcinoma; PET-CT; Prognosis.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell* / diagnostic imaging
  • Carcinoma, Squamous Cell* / surgery
  • Head and Neck Neoplasms*
  • Humans
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / surgery
  • Mouth Neoplasms* / diagnostic imaging
  • Mouth Neoplasms* / surgery
  • Positron Emission Tomography Computed Tomography
  • Prognosis
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck