Lymph Node with the Highest FDG Uptake Predicts Distant Metastasis-Free Survival in Patients with Locally Advanced Nasopharyngeal Carcinoma

Hojin Cho, Sung Hoon Kim, Hyunjeong Kim, Yoonwoo Koh, Se Heon Kim, Eun Chang Choi, Mijin Yun

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Abstract

Purpose Distant failure is a major concern in patients with nasopharyngeal carcinoma. We evaluated whether the metabolic features on 18F-FDG PET/CT can predict distant metastasis-free survival (DMFS) in patients with locally advanced nasopharyngeal carcinoma. Methods We retrospectively reviewed 51 patients stage III, IVA, and IVB nasopharyngeal carcinoma who underwent 18F-FDG PET/CT at staging. The SUVmax for the primary site and the lymph nodes with the highest uptake as well as at the farthest station were divided by the SUVmean of the background liver (TLR, NLR-H, and NLR-F, respectively). The prognostic value of clinicopathologic factors and SUV parameters for predicting DMFS were assessed using a Cox proportional hazards model. Differences in DMFS were examined by the Kaplan-Meier method. Results In the median follow-up period of 50.4 ± 39.3 months (median ± interquartile range; range, 3.8-130.9), distant metastasis developed in 11 patients (21.6%). In univariate analyses, N stage (N3b) (P = 0.003) and NLR-H >5.70 (P = 0.02) were significant prognostic factors for DMFS, and remained significant in multivariate analysis, whereas TLR (P = 0.18) and NLR-F (P = 0.76) did not. The Kaplan-Meier curves showed significantly poorer DMFS in patients with NLR-H >5.70 than in those with lower NLR-H (≤5.70) (1-year DMFS rate, 84.2% vs 93.5%; P = 0.01). Conclusions In addition to anatomical N stage, higher NLR-H on pretreatment 18F-FDG PET/CT is an independent prognostic factor for worse DMFS in patients with locally advanced nasopharyngeal carcinoma.

Original languageEnglish
Pages (from-to)e220-e225
JournalClinical nuclear medicine
Volume43
Issue number7
DOIs
Publication statusPublished - 2018 Jul 1

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Lymph Nodes
Neoplasm Metastasis
Survival
Fluorodeoxyglucose F18
Nasopharyngeal carcinoma
Proportional Hazards Models
Multivariate Analysis
Survival Rate
Liver

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

Cho, Hojin ; Kim, Sung Hoon ; Kim, Hyunjeong ; Koh, Yoonwoo ; Kim, Se Heon ; Choi, Eun Chang ; Yun, Mijin. / Lymph Node with the Highest FDG Uptake Predicts Distant Metastasis-Free Survival in Patients with Locally Advanced Nasopharyngeal Carcinoma. In: Clinical nuclear medicine. 2018 ; Vol. 43, No. 7. pp. e220-e225.
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title = "Lymph Node with the Highest FDG Uptake Predicts Distant Metastasis-Free Survival in Patients with Locally Advanced Nasopharyngeal Carcinoma",
abstract = "Purpose Distant failure is a major concern in patients with nasopharyngeal carcinoma. We evaluated whether the metabolic features on 18F-FDG PET/CT can predict distant metastasis-free survival (DMFS) in patients with locally advanced nasopharyngeal carcinoma. Methods We retrospectively reviewed 51 patients stage III, IVA, and IVB nasopharyngeal carcinoma who underwent 18F-FDG PET/CT at staging. The SUVmax for the primary site and the lymph nodes with the highest uptake as well as at the farthest station were divided by the SUVmean of the background liver (TLR, NLR-H, and NLR-F, respectively). The prognostic value of clinicopathologic factors and SUV parameters for predicting DMFS were assessed using a Cox proportional hazards model. Differences in DMFS were examined by the Kaplan-Meier method. Results In the median follow-up period of 50.4 ± 39.3 months (median ± interquartile range; range, 3.8-130.9), distant metastasis developed in 11 patients (21.6{\%}). In univariate analyses, N stage (N3b) (P = 0.003) and NLR-H >5.70 (P = 0.02) were significant prognostic factors for DMFS, and remained significant in multivariate analysis, whereas TLR (P = 0.18) and NLR-F (P = 0.76) did not. The Kaplan-Meier curves showed significantly poorer DMFS in patients with NLR-H >5.70 than in those with lower NLR-H (≤5.70) (1-year DMFS rate, 84.2{\%} vs 93.5{\%}; P = 0.01). Conclusions In addition to anatomical N stage, higher NLR-H on pretreatment 18F-FDG PET/CT is an independent prognostic factor for worse DMFS in patients with locally advanced nasopharyngeal carcinoma.",
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Lymph Node with the Highest FDG Uptake Predicts Distant Metastasis-Free Survival in Patients with Locally Advanced Nasopharyngeal Carcinoma. / Cho, Hojin; Kim, Sung Hoon; Kim, Hyunjeong; Koh, Yoonwoo; Kim, Se Heon; Choi, Eun Chang; Yun, Mijin.

In: Clinical nuclear medicine, Vol. 43, No. 7, 01.07.2018, p. e220-e225.

Research output: Contribution to journalArticle

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T1 - Lymph Node with the Highest FDG Uptake Predicts Distant Metastasis-Free Survival in Patients with Locally Advanced Nasopharyngeal Carcinoma

AU - Cho, Hojin

AU - Kim, Sung Hoon

AU - Kim, Hyunjeong

AU - Koh, Yoonwoo

AU - Kim, Se Heon

AU - Choi, Eun Chang

AU - Yun, Mijin

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N2 - Purpose Distant failure is a major concern in patients with nasopharyngeal carcinoma. We evaluated whether the metabolic features on 18F-FDG PET/CT can predict distant metastasis-free survival (DMFS) in patients with locally advanced nasopharyngeal carcinoma. Methods We retrospectively reviewed 51 patients stage III, IVA, and IVB nasopharyngeal carcinoma who underwent 18F-FDG PET/CT at staging. The SUVmax for the primary site and the lymph nodes with the highest uptake as well as at the farthest station were divided by the SUVmean of the background liver (TLR, NLR-H, and NLR-F, respectively). The prognostic value of clinicopathologic factors and SUV parameters for predicting DMFS were assessed using a Cox proportional hazards model. Differences in DMFS were examined by the Kaplan-Meier method. Results In the median follow-up period of 50.4 ± 39.3 months (median ± interquartile range; range, 3.8-130.9), distant metastasis developed in 11 patients (21.6%). In univariate analyses, N stage (N3b) (P = 0.003) and NLR-H >5.70 (P = 0.02) were significant prognostic factors for DMFS, and remained significant in multivariate analysis, whereas TLR (P = 0.18) and NLR-F (P = 0.76) did not. The Kaplan-Meier curves showed significantly poorer DMFS in patients with NLR-H >5.70 than in those with lower NLR-H (≤5.70) (1-year DMFS rate, 84.2% vs 93.5%; P = 0.01). Conclusions In addition to anatomical N stage, higher NLR-H on pretreatment 18F-FDG PET/CT is an independent prognostic factor for worse DMFS in patients with locally advanced nasopharyngeal carcinoma.

AB - Purpose Distant failure is a major concern in patients with nasopharyngeal carcinoma. We evaluated whether the metabolic features on 18F-FDG PET/CT can predict distant metastasis-free survival (DMFS) in patients with locally advanced nasopharyngeal carcinoma. Methods We retrospectively reviewed 51 patients stage III, IVA, and IVB nasopharyngeal carcinoma who underwent 18F-FDG PET/CT at staging. The SUVmax for the primary site and the lymph nodes with the highest uptake as well as at the farthest station were divided by the SUVmean of the background liver (TLR, NLR-H, and NLR-F, respectively). The prognostic value of clinicopathologic factors and SUV parameters for predicting DMFS were assessed using a Cox proportional hazards model. Differences in DMFS were examined by the Kaplan-Meier method. Results In the median follow-up period of 50.4 ± 39.3 months (median ± interquartile range; range, 3.8-130.9), distant metastasis developed in 11 patients (21.6%). In univariate analyses, N stage (N3b) (P = 0.003) and NLR-H >5.70 (P = 0.02) were significant prognostic factors for DMFS, and remained significant in multivariate analysis, whereas TLR (P = 0.18) and NLR-F (P = 0.76) did not. The Kaplan-Meier curves showed significantly poorer DMFS in patients with NLR-H >5.70 than in those with lower NLR-H (≤5.70) (1-year DMFS rate, 84.2% vs 93.5%; P = 0.01). Conclusions In addition to anatomical N stage, higher NLR-H on pretreatment 18F-FDG PET/CT is an independent prognostic factor for worse DMFS in patients with locally advanced nasopharyngeal carcinoma.

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