Post-operative PET/CT improves the detection of early recurrence of squamous cell carcinomas of the oral cavity Journal Article
| Authors: | Yu, Y.; Schöder, H.; Zakeri, K.; Chen, L.; Kang, J. J.; McBride, S. M.; Tsai, C. J.; Gelblum, D. Y.; Boyle, J. O.; Cracchiolo, J. R.; Cohen, M. A.; Singh, B.; Ganly, I.; Patel, S. G.; Michel, L. S.; Dunn, L.; Sherman, E. J.; Pfister, D. G.; Wong, R. J.; Riaz, N.; Lee, N. Y. |
| Article Title: | Post-operative PET/CT improves the detection of early recurrence of squamous cell carcinomas of the oral cavity |
| Abstract: | Background: We evaluate the impact of post-operative 18-fluorodeoxyglucose positron emission tomography with computed tomography (PET/CT) for radiation planning on the detection of early recurrence (ER) and treatment outcomes in oral squamous cell carcinoma (OSCC). Methods: We retrospectively reviewed the records of patients treated with post-operative radiation between 2005 and 2019 for OSCC at our institution. Extracapsular extension and positive surgical margins were classified as high risk features; pT3-4, node positivity, lymphovascular invasion, perineural invasion, tumor thickness >5 mm, and close surgical margins were considered intermediate risk features. Patients with ER were identified. Inverse probability of treatment weighting (IPTW) was used to adjust for imbalances between baseline characteristics. Results: 391 patients with OSCC were treated with post-operative radiation. 237 (60.6%) patients underwent post-operative PET/CT planning vs. 154 (39.4%) who were planned with CT only. Patients screened with post-operative PET/CT were more likely to be diagnosed with ER than those planned with CT only (16.5 vs. 3.3%, p < 0.0001). Among patients with ER, those with intermediate features were more likely than those high risk features to undergo major treatment intensification, including re-operation, the addition of chemotherapy, or intensification of radiation by ≥ 10 Gy (91% vs. 9%, p < 0.0001). Post-operative PET/CT was associated with improved disease-free and overall survival for patients with intermediate risk features (IPTW log-rank p = 0.026 and p = 0.047, respectively) but not high risk features (IPTW log-rank p = 0.44 and p = 0.96). Conclusions: Use of post-operative PET/CT is associated with increased detection of early recurrence. Among patients with intermediate risk features, this may translate to improved disease-free survival. © 2023 |
| Keywords: | radiation; pet/ct; oral cavity cancer; early recurrence; post-operative |
| Journal Title: | Oral Oncology |
| Volume: | 141 |
| ISSN: | 1368-8375 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2023-06-01 |
| Start Page: | 106400 |
| Language: | English |
| DOI: | 10.1016/j.oraloncology.2023.106400 |
| PROVIDER: | scopus |
| PUBMED: | 37099979 |
| PMCID: | PMC10631462 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Nancy Y. Lee -- Source: Scopus |
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