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Lupato V, Giacomarra V, Alfieri S, Fanetti G, Polesel J. Prognostic factors in salvage surgery for recurrent head and neck cancer: A systematic review and meta-analysis. Crit Rev Oncol Hematol 2021; 169:103550. [PMID: 34843929 DOI: 10.1016/j.critrevonc.2021.103550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Although salvage surgery (SS) is considered the best curative choice in recurrent head and neck cancer, the identification of patients who can benefit the most from this treatment is challenging. METHODS We systematically reviewed the prognostic role of pre- and post-surgery factors in patients undergoing SS for recurrent head and neck cancer (oral cavity, oropharynx, hypopharynx, and larynx). RESULTS Twenty-five studies met the inclusion criteria out of 1280 screened citations. Pre-surgery factors significantly associated with worse overall survival were age>60 years, advanced initial stage, early recurrence, and regional recurrence; no heterogeneity between study emerged. Among post- surgery factors, worse survival emerged for positive surgical margins, extracapsular extension and perineural invasion. CONCLUSION The identification of pre-surgery factors associated with poor outcomes may help the selection of the best candidate to SS; alternative treatments should be considered for high-risk patients. Post-surgery predictors of worse prognosis may guide clinicians in tailoring patients' surveillance.
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Affiliation(s)
- Valentina Lupato
- Unit of Otolaryngology, Azienda Sanitaria Friuli Occidentale (ASFO), Pordenone, Italy
| | - Vittorio Giacomarra
- Unit of Otolaryngology, Azienda Sanitaria Friuli Occidentale (ASFO), Pordenone, Italy
| | - Salvatore Alfieri
- Division of Medical Oncology and Immune-related Tumors, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Giuseppe Fanetti
- Division of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Jerry Polesel
- Unit of Cancer Epidemiology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy.
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Fujima N, Andreu-Arasa VC, Meibom SK, Mercier GA, Salama AR, Truong MT, Sakai O. Prediction of the treatment outcome using machine learning with FDG-PET image-based multiparametric approach in patients with oral cavity squamous cell carcinoma. Clin Radiol 2021; 76:711.e1-711.e7. [PMID: 33934877 DOI: 10.1016/j.crad.2021.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 03/26/2021] [Indexed: 12/15/2022]
Abstract
AIM To investigate the value of machine learning-based multiparametric analysis using 2-[18F]-fluoro-2-deoxy-d-glucose positron-emission tomography (FDG-PET) images to predict treatment outcome in patients with oral cavity squamous cell carcinoma (OCSCC). MATERIALS AND METHODS Ninety-nine patients with OCSCC who received pretreatment integrated FDG-PET/computed tomography (CT) were included. They were divided into the training (66 patients) and validation (33 patients) cohorts. The diagnosis of local control or local failure was obtained from patient's medical records. Conventional FDG-PET parameters, including the maximum and mean standardised uptake values (SUVmax and SUVmean), metabolic tumour volume (MTV), and total lesion glycolysis (TLG), quantitative tumour morphological parameters, intratumoural histogram, and texture parameters, as well as T-stage and clinical stage, were evaluated by a machine learning analysis. The diagnostic ability of T-stage, clinical stage, and conventional FDG-PET parameters (SUVmax, SUVmean, MTV, and TLG) was also assessed separately. RESULTS In support-vector machine analysis of the training dataset, the final selected parameters were T-stage, SUVmax, TLG, morphological irregularity, entropy, and run-length non-uniformity. In the validation dataset, the diagnostic performance of the created algorithm was as follows: sensitivity 0.82, specificity 0.7, positive predictive value 0.86, negative predictive value 0.64, and accuracy 0.79. In a univariate analysis using conventional FDG-PET parameters, T-stage and clinical stage, diagnostic accuracy of each variable was revealed as follows: 0.61 in T-stage, 0.61 in clinical stage, 0.64 in SUVmax, 0.61 in SUVmean, 0.64 in MTV, and 0.7 in TLG. CONCLUSION A machine-learning-based approach to analysing FDG-PET images by multiparametric analysis might help predict local control or failure in patients with OCSCC.
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Affiliation(s)
- N Fujima
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, USA; Research Center for Cooperative Projects, Hokkaido University Graduate School of Medicine, Japan
| | - V C Andreu-Arasa
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, USA
| | - S K Meibom
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, USA
| | - G A Mercier
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, USA
| | - A R Salama
- Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, USA; Department of Oral & Maxillofacial Surgery, Boston Medical Center, Boston University Henry M. Goldman School of Dental Medicine, USA
| | - M T Truong
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, USA
| | - O Sakai
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, USA; Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, USA; Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, USA.
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Gao A, Pan X, Yang X, Lin Z. Predictive factors in the treatment of oral squamous cell carcinoma using PD-1/PD-L1 inhibitors. Invest New Drugs 2021; 39:1132-1138. [PMID: 33594603 DOI: 10.1007/s10637-021-01082-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 02/08/2021] [Indexed: 12/16/2022]
Abstract
Due to immune impairment and lymphocyte enrichment of oral squamous cell carcinoma (OSCC), anti-PD-1/PD-L1 therapy is regarded as a potential treatment option. However, tumor heterogeneity, differences in the immune conditions of patients, and the interrelation between tumor cells and stromal cells within the tumor microenvironment (TME) could affect the therapeutic efficacy of immune checkpoint blockades. Therefore, to maximize the benefit of blockade PD-1/PD-L1 axis, to find an efficient predictor (the possible clinical parameters or biological factors) before treatment are of great importance. In this review, we discuss the advantages of anti-PD-1/PD-L1 therapy for OSCC patients and find three respects that are currently available in predicting curative effect. Firstly, OSCC with high PD-L1 expression evaluating by immunohistochemistry (high tumor proportion score (TPS) and combined positive score (CPS)) are considered to be suitable for anti-PD-1/PD-L1 therapy. Secondly, gene-level predictive biomarkers including high metastatic mismatch repair deficiency (dMMR) signature or enrichment of interferon-γ and PD1 signaling pathway is expected to be favorable factors. Besides, PET/CT parameters (SUVmax, MTV, TLG) are proved to be correlated with PD-L1 expression, and some newly developed immunoPET probes are enlarging the application of PET/CT in predicting therapeutic efficacy of PD-1/PD-L1 inhibitors.
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Affiliation(s)
- Antian Gao
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Zhong Yang Road 30, Nanjing City, Jiangsu Province, 210008, People's Republic of China
| | - Xiao Pan
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Zhong Yang Road 30, Nanjing City, Jiangsu Province, 210008, People's Republic of China
| | - Xudong Yang
- Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Medical School of Nanjing University, Zhong Yang Road 30, Nanjing City, Jiangsu Province, 210008, People's Republic of China.
| | - Zitong Lin
- Department of Dentomaxillofacial Radiology, Nanjing Stomatological Hospital, Medical School of Nanjing University, Zhong Yang Road 30, Nanjing City, Jiangsu Province, 210008, People's Republic of China.
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Creff G, Devillers A, Depeursinge A, Palard-Novello X, Acosta O, Jegoux F, Castelli J. Evaluation of the Prognostic Value of FDG PET/CT Parameters for Patients With Surgically Treated Head and Neck Cancer: A Systematic Review. JAMA Otolaryngol Head Neck Surg 2021; 146:471-479. [PMID: 32215611 DOI: 10.1001/jamaoto.2020.0014] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Head and neck squamous cell cancer (HNSCC) represents the seventh most frequent cancer worldwide. More than half of the patients diagnosed with HNSCC are treated with primary surgery. Objective To report the available evidence on the value of quantitative parameters of fluorodeoxyglucose F 18-labeled positron emission tomography and computed tomography (FDG-PET/CT) performed before surgical treatment of HNSCC to estimate overall survival (OS), disease-free survival (DFS), and distant metastasis (DM) and to discuss their limitations. Evidence Review A systematic review of the English-language literature in PubMed/MEDLINE and ScienceDirect published between January 2003 and February 15, 2019, was performed between March 1 and July 27, 2019, to identify articles addressing the association between preoperative FDG-PET/CT parameters and oncological outcomes among patients with HNSCC. Articles included those that addressed the following: (1) cancer of the oral cavity, oropharynx, hypopharynx, or larynx; (2) surgically treated (primary or for salvage); (3) pretreatment FDG-PET/CT; (4) quantitative or semiquantitative evaluation of the FDG-PET/CT parameters; and (5) the association between the value of FDG-PET/CT parameters and clinical outcomes. Quality assessment was performed using the Oxford Centre for Evidence-Based Medicine level of evidence. Findings A total of 128 studies were retrieved from the databases, and 36 studies met the inclusion criteria; these studies comprised 3585 unique patients with a median follow-up of 30.6 months (range, 16-53 months). Of these 36 studies, 32 showed an association between at least 1 FDG-PET/CT parameter and oncological outcomes (OS, DFS, and DM). The FDG-PET/CT volumetric parameters (metabolic tumor volume [MTV] and total lesion glycolysis [TLG]) were independent prognostic factors in most of the data, with a higher prognostic value than the maximum standard uptake value (SUVmax). For example, in univariate analysis of OS, the SUVmax was correlated with OS in 5 of 11 studies, MTV in 11 of 12 studies, and TLG in 6 of 9 studies. The spatial distribution of metabolism via textural indices seemed promising, although that factor is currently poorly evaluated: only 3 studies analyzed data from radiomics indices. Conclusions and Relevance The findings of this study suggest that the prognostic effectiveness of FDG-PET/CT parameters as biomarkers of OS, DFS, and DM among patients with HNSCC treated with surgery may be valuable. The volumetric parameters (MTV and TLG) seemed relevant for identifying patients with a higher risk of postsurgical disease progression who could receive early therapeutic intervention to improve their prognosis. However, further large-scale studies including exclusively surgery-treated patients stratified according to localization and further analysis of the textural indices are required to define a reliable FDG-PET/CT-based prognostic model of mortality and recurrence risk for these patients.
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Affiliation(s)
- Gwenaelle Creff
- Department of Otolaryngology-Head and Neck Surgery, Rennes University Hospital, Rennes, France
| | - Anne Devillers
- Department of Nuclear Medicine, Centre Eugène Marquis, Rennes, France
| | - Adrien Depeursinge
- University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | | | - Oscar Acosta
- LTSI (Image and Signal Processing Laboratory), INSERM, U1099, Rennes, France
| | - Franck Jegoux
- Department of Otolaryngology-Head and Neck Surgery, Rennes University Hospital, Rennes, France
| | - Joel Castelli
- Department of Radiation Oncology, Cancer Institute Eugène Marquis, Rennes, France
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Yang L, Liu F, Wu Y, Fang Q, Zhang X, Du W, Zhang X, Chen D, Luo R. Predictive Value of Occult Metastasis and Survival Significance of Metabolic Tumor Volume Determined by PET-CT in cT1-2N0 Squamous Cell Carcinoma of the Tongue. Front Oncol 2020; 10:542530. [PMID: 33425715 PMCID: PMC7793868 DOI: 10.3389/fonc.2020.542530] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 10/26/2020] [Indexed: 12/17/2022] Open
Abstract
Objectives Our goal was to analyze the possibility of using metabolic tumor volume (MTV) to predict occult cervical metastasis and survival in cT1-2N0 squamous cell carcinoma (SCC) of the tongue. Methods Data on the primary tumor MTV and cervical node status as determined by the maximum standardized uptake value were retrieved. The sensitivity and specificity in predicting occult metastasis were calculated with a fourfold table. Associations between occult metastasis and clinicopathological variables were evaluated by univariate and multivariate analyses. The main study endpoints were locoregional control (LRC) and disease-specific survival (DSS). Results A total of 24 (20.3%) of 118 patients had occult metastasis. An MTV cutoff value of 4.3 cm3 showed a sensitivity of 50.0% and a specificity of 76.6% in predicting occult metastasis. The sensitivity and specificity of PET-CT in predicting occult metastasis in cT1 tumors were 66.6 and 89.8%, respectively, with values of 83.3 and 67.3%, respectively, when combined with the MTV. The sensitivity and specificity of PET-CT in predicting occult metastasis in cT2 tumors were 72.2 and 82.2%, respectively, with values of 88.9 and 57.8%, respectively, when combined with the MTV. Patients with MTV ≥4.3 cm3 had a higher occult metastasis rate than patients with MTV <4.3 cm3. The 5-year LRC and DSS rates were 86 and 94%, respectively, in patients with MTV <4.3 cm3 and 54 and 72%, respectively, in patients with MTV ≥4.3 cm3. Both differences were found to be significant in univariate and multivariate analyses. Conclusions MTV ≥4.3 cm3 was associated with an increased probability of occult metastasis and lower LRC and DSS rates in early-stage SCC of the tongue.
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Affiliation(s)
- Lijie Yang
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fei Liu
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yao Wu
- Department of Stomatology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Qigen Fang
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Xiaojun Zhang
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Wei Du
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Xu Zhang
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Defeng Chen
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Ruihua Luo
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
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Topkan E, Selek U, Mertsoylu H, Ozdemir Y, Kucuk A, Torun N, Besen AA. Pretreatment Photopenia on 18F-Fluorodeoxyglucose Positron Emission Tomography-Computed Tomography Scans Predicts Poor Prognosis in Nasopharyngeal Cancer Patients Undergoing Concurrent Chemoradiotherapy. Clin Exp Otorhinolaryngol 2020; 13:407-414. [PMID: 32075362 PMCID: PMC7669310 DOI: 10.21053/ceo.2019.01298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/04/2019] [Accepted: 10/24/2019] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To investigate the influence of pretreatment primary tumor or nodal photopenia (PP) on 18F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT), an indicator of tumor ischemia, on survival results of nasopharyngeal cancers (NPCs) treated with concurrent chemoradiotherapy (C-CRT). METHODS The pre-C-CRT FDG PET-CT scans of 104 patients with NPC (cT1-4 N0-3 M0) were retrospectively examined to determine the presence of PP (PP+). Our primary endpoint was the influence of PP+ on overall survival (OS), while the progression-free survival (PFS) and locoregional PFS (LRPFS) constituted the secondary endpoints. RESULTS The PP+ was detected in 29 (27.9%): nine (8.7%), seven (6.7%), and 13 (12.5%) in the primary tumor alone, primary tumor plus neck nodes, and neck nodes alone, respectively. Because the PP+ cases were small by count per location, all comparative analyses were performed according to overall PP+/ PP- status instead of per detected site. At a median follow-up of 67.8 months (range, 9 to 130 months), the median survival times were not reached (NR) for the entire population, while 5-year OS, LRPFS, and PFS rates were 73.3%, 68.2%, and 63.4%, respectively. Comparatively the PP+ patients exhibited significantly poorer median OS (49.8 months vs. NR, P<0.001), LRPFS (40.7 months vs. NR, P=0.001), and PFS (31.8 months vs. NR, P=0.002) durations than their PP- counterparts. Furthermore, the PP+ retained its independent prognostic significance in multivariate analysis (P<0.001). CONCLUSION Present results uncovered the pre-C-CRT PP as an independent predictor of poor prognosis for NPC patients, which underscore the requirement for the fortification of the local and systemic treatments in hypoxic NPCs.
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Affiliation(s)
- Erkan Topkan
- Department of Radiation Oncology, Baskent University Medical Faculty, Adana, Turkey
| | - Ugur Selek
- Department of Radiation Oncology, Koc University School of Medicine, Istanbul, Turkey
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hüseyin Mertsoylu
- Department of Medical Oncology, Baskent University Medical Faculty, Adana, Turkey
| | - Yurday Ozdemir
- Department of Radiation Oncology, Baskent University Medical Faculty, Adana, Turkey
| | - Ahmet Kucuk
- Clinics of Radiation Oncology, Mersin City Hospital, Mersin, Turkey
| | - Nese Torun
- Department of Nuclear Medicine, Baskent University Medical Faculty, Adana, Turkey
| | - Ali Ayberk Besen
- Department of Medical Oncology, Baskent University Medical Faculty, Adana, Turkey
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Fujima N, Andreu-Arasa VC, Meibom SK, Mercier GA, Salama AR, Truong MT, Sakai O. Deep learning analysis using FDG-PET to predict treatment outcome in patients with oral cavity squamous cell carcinoma. Eur Radiol 2020; 30:6322-6330. [PMID: 32524219 DOI: 10.1007/s00330-020-06982-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 04/20/2020] [Accepted: 05/26/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To assess the utility of deep learning analysis using 18F-fluorodeoxyglucose (FDG) uptake by positron emission tomography (PET/CT) to predict disease-free survival (DFS) in patients with oral cavity squamous cell carcinoma (OCSCC). METHODS One hundred thirteen patients with OCSCC who received pretreatment FDG-PET/CT were included. They were divided into training (83 patients) and test (30 patients) sets. The diagnosis of treatment control/failure and the DFS rate were obtained from patients' medical records. In deep learning analyses, three planes of axial, coronal, and sagittal FDG-PET images were assessed by ResNet-101 architecture. In the training set, image analysis was performed for the diagnostic model creation. The test data set was subsequently analyzed for confirmation of diagnostic accuracy. T-stage, clinical stage, and conventional FDG-PET parameters (the maximum and mean standardized uptake value (SUVmax and SUVmean), heterogeneity index, metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were also assessed with determining the optimal cutoff from training dataset and then validated their diagnostic ability from test dataset. RESULTS In dividing into patients with treatment control and failure, the highest diagnostic accuracy of 0.8 was obtained using deep learning classification, with a sensitivity of 0.8, specificity of 0.8, positive predictive value of 0.89, and negative predictive value of 0.67. In the Kaplan-Meier analysis, the DFS rate was significantly different only with the analysis of deep learning-based classification (p < .01). CONCLUSIONS Deep learning-based diagnosis with FDG-PET images may predict treatment outcome in patients with OCSCC. KEY POINTS • Deep learning-based diagnosis of FDG-PET images showed the highest diagnostic accuracy to predict the treatment outcome in patients with oral cavity squamous cell carcinoma. • Deep learning-based diagnosis was shown to differentiate patients between good and poor disease-free survival more clearly than conventional T-stage, clinical stage, and conventional FDG-PET-based parameters.
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Affiliation(s)
- Noriyuki Fujima
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA.,Research Center for Cooperative Projects, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - V Carlota Andreu-Arasa
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA
| | - Sara K Meibom
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA
| | - Gustavo A Mercier
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA
| | - Andrew R Salama
- Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, USA.,Department of Oral & Maxillofacial Surgery, Boston Medical Center, Boston University Henry M. Goldman School of Dental Medicine, Boston, USA
| | - Minh Tam Truong
- Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, USA
| | - Osamu Sakai
- Department of Radiology, Boston Medical Center, Boston University School of Medicine, FGH Building, 3rd Floor, 820 Harrison Avenue, Boston, MA, 02118, USA. .,Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston University School of Medicine, Boston, USA. .,Department of Radiation Oncology, Boston Medical Center, Boston University School of Medicine, Boston, USA.
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Prognostic value of neutrophil-to-lymphocyte ratio and its correlation with fluorine-18-fluorodeoxyglucose metabolic parameters in intrahepatic cholangiocarcinoma submitted to 90Y-radioembolization. Nucl Med Commun 2020; 41:78-86. [PMID: 31800510 DOI: 10.1097/mnm.0000000000001123] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the prognostic value of neutrophil-to-lymphocyte ratio (NLR) and its relationship with several metabolic parameters obtained through PET in intrahepatic cholangiocarcinoma (ICC) submitted to radioembolization with Y-microspheres (Y-radioembolization). METHODS Records of 20 subjects affected by ICC and submitted to Y-radioembolization were retrospectively evaluated. In all cases, pretreatment NLR was carried out and fluorine-18-fluorodeoxyglucose (F-FDG) PET/CT was acquired with the calculation of the following metabolic parameters: maximum and mean standardized uptake value (SUVmax and SUVmean), metabolic total volume and total lesion glycolysis. After Y-radioembolization, all patients underwent regular imaging and laboratory follow-up. RESULTS All patients presented F-FDG-avid hepatic tumors at pretreatment PET/CT examination. NLR significantly correlated with SUVmax (r = 0.64; P = 0.002) and SUVmean (r = 0.67; P = 0.001). After treatment with Y-microspheres, the mean OS resulted 12.5 ± 1.5 months. When the average pretreatment NLR value (i.e. 2.7) was used as a cutoff for patients' stratification, subjects with low NLR (<2.7) had a significantly longer OS than those with high NLR (>2.7). At Cox regression analysis including bilirubin, age, the presence of extrahepatic disease, hepatitis C virus/hepatitis B virus status and PET-derived parameters, only NLR resulted to be a significant predictor of OS (P = 0.01; hazard ratio = 13.1, 95% confidence interval = 1.6-102.7). CONCLUSION NLR is correlated with SUVmax-mean values in ICC and resulted to be an easy available predictor of survival in patients submitted to treatment with Y-microspheres.
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Camacho MR, Etchebehere E, Tardelli N, Delamain MT, Vercosa AF, Takahashi ME, Brunetto SQ, Metze IG, Souza CA, Cerci JJ, Ramos CD. Validation of a Multifocal Segmentation Method for Measuring Metabolic Tumor Volume in Hodgkin Lymphoma. J Nucl Med Technol 2019; 48:30-35. [DOI: 10.2967/jnmt.119.231118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 08/21/2019] [Indexed: 12/14/2022] Open
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