Defining risk groups of patients with cancer of unknown primary site and cervical nodal metastases by F-18 fluorodeoxyglucose positron emission tomography and computed tomography imaging

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• 作者：Yung-Yueh Su^a ; Shih-Shin Chen^a ; Chia-Hsun Hsieh^b ; ^c ; Chun-Ta Liao^c ; ^d ; Chien-Yu Lin^c ; ^e ; Chung-Jan Kang^c ; ^d ; Tzu-Chen Yen^c ; ^f ; ^{yentc1110@gmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Head and neck neoplasm ; PET scan ; Unknown primary tumors
• 刊名：The Kaohsiung Journal of Medical Sciences
• 出版年：2016
• 出版时间：August 2016
• 年：2016
• 卷：32
• 期：8
• 页码：407-413
• 全文大小：649 K

文摘

We sought to investigate the clinical utility of F-18 fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT) in Taiwanese patients with cancer of unknown primary site (CUP) and cervical nodal metastases. We also aimed to study the impact of F-18 FDG PET/CT on clinical treatment priority in this patient group. Between September 2006 and May 2014, patients with CUP and cervical nodal metastases who underwent F-18 FDG PET/CT imaging study were retrospectively identified. The clinicopathological risk factors and PET parameters were analyzed in relation to 2-year overall survival (OS) rates using univariate and multivariate analyses. Two-year OS curves were plotted with the Kaplan–Meier method. Of the eligible patients (n = 54), 12 (22.2%) had distant metastases (DM) at presentation. A total of 13 (24.1%) and 15 (27.8%) primary tumors were identified by FDG PET/CT imaging and an additional triple biopsy, respectively. The results of multivariate analysis identified smoking [p = 0.033, 95% confidence interval (CI) = 1.197−40.342], a maximum standardized uptake value (SUV_max) of cervical nodes ≥ 14.2 (p = 0.035, 95% CI = 1.134−28.029), and DM at presentation (p = 0.031, 95% CI = 1.257−114.854) as independent predictors of 2-year OS. Specifically, patients who carried ≥ 2 risk factors showed poorer outcomes (70.3% vs. 11.8%, p < 0.001). Fifteen study patients (27.8%) had their treatment modified by FDG PET/CT findings. We conclude that FDG PET/CT is clinically useful in CUP patients not only for tumor staging, but also for modifying treatment regimens.