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Research ArticleHead & Neck

Negative Predictive Value of Surveillance PET/CT in Head and Neck Squamous Cell Cancer

M. McDermott, M. Hughes, T. Rath, J.T. Johnson, D.E. Heron, G.J. Kubicek, S.W. Kim, R.L. Ferris, U. Duvvuri, J.P. Ohr and B.F. Branstetter
American Journal of Neuroradiology August 2013, 34 (8) 1632-1636; DOI: https://doi.org/10.3174/ajnr.A3494
M. McDermott
aFrom the Department of Radiology (M.M.), New York University, New York, New York
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M. Hughes
bDepartments of Radiology (M.H., T.R., B.F.B.)
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T. Rath
bDepartments of Radiology (M.H., T.R., B.F.B.)
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J.T. Johnson
cOtolaryngology (J.T.J., D.E.H., S.W.K., R.L.F., U.D., B.F.B.)
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D.E. Heron
cOtolaryngology (J.T.J., D.E.H., S.W.K., R.L.F., U.D., B.F.B.)
dRadiation Oncology (D.E.H.)
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G.J. Kubicek
fDepartment of Radiation Oncology (G.J.K.), Cooper University Hospital, Camden, New Jersey.
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S.W. Kim
cOtolaryngology (J.T.J., D.E.H., S.W.K., R.L.F., U.D., B.F.B.)
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R.L. Ferris
cOtolaryngology (J.T.J., D.E.H., S.W.K., R.L.F., U.D., B.F.B.)
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U. Duvvuri
cOtolaryngology (J.T.J., D.E.H., S.W.K., R.L.F., U.D., B.F.B.)
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J.P. Ohr
eMedical Oncology (J.P.O.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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B.F. Branstetter
bDepartments of Radiology (M.H., T.R., B.F.B.)
cOtolaryngology (J.T.J., D.E.H., S.W.K., R.L.F., U.D., B.F.B.)
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    Fig 1.

    Data flow chart of patient selection.

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    Fig 2.

    Disease-free survival curve of patients with negative findings on PET-CT surveillance examinations after treatment for HNSCC. Time zero was chosen as the date of first PET/CT examination with negative findings.

Tables

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    Table 1:

    Patient demographics, TNM stages, and therapya

    Demographics and Staging
    Age (yr)
        Median61
        Range21–89
    Sex
        Male388 (76%)
        Female124 (24%)
    Site of origin (n = 419)
        Oropharynx130 (31%)
        Oral cavity130 (31%)
        Larynx63 (15%)
        Maxillofacial/sinus37 (9%)
        Hypopharynx26 (6%)
        Nasopharynx12 (3%)
        Trans-spatial10 (2%)
        Unknown primary8 (2%)
    T stage (n = 428)
        T09 (2%)
        T1109 (25%)
        T2124 (29%)
        T385 (20%)
        T4101 (24%)
    N stage (n = 440)
        N0192 (44%)
        N169 (16%)
        N2162 (37%)
        N317 (4%)
    M stage (n = 369)
        M0365 (99%)
        M14 (1%)
    Therapy (n = 512)
        CRT alone67 (13%)
        Surgery plus CRT445 (87%)
    • Note:—CRT indicates chemoradiation therapy; N, node; M, metastasis.

    • ↵a A total of 512 patients were included in this study, but not all patients had initial staging data available, so fewer patients are included. The number of patients with available data is listed in the header for each section.

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    Table 2:

    Primary site of origin and tumor stagea

    Site of OriginT1T2T3T4
    Oropharynx25422130
    Oral cavity31341734
    Larynx10152111
    Maxillofacial and sinus (parotid, skin, nasal cavity, orbit lip, sinus, maxilla)55510
    Hypopharynx4495
    Nasopharynx0116
    Trans-spatial0226
    • ↵a Fewer patients are listed in Table 2 than in Table 1 because some patients had incomplete data in the registry. Three patients had unknown primaries.

    • View popup
    Table 3:

    Primary site of origin and tumor stage for the subset of 214 patients with negative PET/CT findingsa

    Site of OriginT1T2T3T4
    Oropharynx253278
    Oral cavity1815713
    Larynx3794
    Maxillofacial and sinus (parotid, skin, nasal cavity, orbit lip, sinus, maxilla)3333
    Hypopharynx2423
    Nasopharynx0134
    Trans-spatial0111
    • ↵a The site of primary tumor and tumor stage were available from 182 of the 214 patients with negative PET/CT findings. No patients were recorded as having unknown primaries in the data base from this subset of patients.

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    Table 4:

    Clinical Information of the 19 patients with negative PET/CT findings who had a recurrence

    PatientSite of OriginTNM StageLocation of RecurrenceTime Interval between Negative PET/CT Findings and Recurrence (mo)
    1OropharynxT2N2cM0Local7.5
    2MaxillofacialNot recordedRegional12.7
    3OropharynxT3N2cM0Local26.4
    4OropharynxNot recordedRegional7.5
    5MaxillofacialNot recordedDistant11.4
    6LarynxT2N0M0Local9.0
    7Unknown primaryT0N2bM0Regional27.5
    8Unknown primaryT0N2bM0Regional23.0
    9HypopharynxT4N2bM0Local6.9
    10HypopharynxT2N2bM0Local3.7
    11LarynxT2N0M0Local3.0
    12OropharynxT3N0M0Local4.6
    13OropharynxT4N1M0Local9.5
    14Oral cavityNot recordedDistant7.1
    15Oral cavityT3N1M0Regional37.3
    16Oral cavityT3N2cM0Local16.9
    17Oral cavity, larynxT2N2cM0Regional4.8
    18LarynxNot recordedLocal12.3
    19Oral cavityNot recordedLocal12.7
    • Note:—TNM indicates tumor, node, metastasis.

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American Journal of Neuroradiology: 34 (8)
American Journal of Neuroradiology
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1 Aug 2013
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M. McDermott, M. Hughes, T. Rath, J.T. Johnson, D.E. Heron, G.J. Kubicek, S.W. Kim, R.L. Ferris, U. Duvvuri, J.P. Ohr, B.F. Branstetter
Negative Predictive Value of Surveillance PET/CT in Head and Neck Squamous Cell Cancer
American Journal of Neuroradiology Aug 2013, 34 (8) 1632-1636; DOI: 10.3174/ajnr.A3494

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Negative Predictive Value of Surveillance PET/CT in Head and Neck Squamous Cell Cancer
M. McDermott, M. Hughes, T. Rath, J.T. Johnson, D.E. Heron, G.J. Kubicek, S.W. Kim, R.L. Ferris, U. Duvvuri, J.P. Ohr, B.F. Branstetter
American Journal of Neuroradiology Aug 2013, 34 (8) 1632-1636; DOI: 10.3174/ajnr.A3494
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