Jeffery B Jorgensen1, Russell B Smith2, Andrew Coughlin3, William C Spanos4, Michele M Lohr4, Steven M Sperry5, Oleg Militsakh3, Robert P Zitsch1, Bevan Yueh6, Laura M Dooley1, Aru Panwar3, Tabitha L I Galloway1, Nitin A Pagedar5. 1. 1 Department of Otolaryngology-Head and Neck Surgery, School of Medicine, University of Missouri, Columbia, Missouri, USA. 2. 2 Division of Surgical Oncology, Baptist MD Anderson Cancer Center, Jacksonville, Florida, USA. 3. 3 Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA. 4. 4 Department of Otolaryngology-Head and Neck Surgery, Sanford Health, Sioux Falls, South Dakota, USA. 5. 5 Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, USA. 6. 6 Department of Otolaryngology, University of Minnesota, Minneapolis, Minnesota, USA.
Abstract
OBJECTIVE: To understand the effects of positron emission tomography/computed tomography (PET/CT) evaluation on patients with previously untreated head and neck squamous cell carcinoma (HNSCC) with clinical evidence of regional lymph node involvement. STUDY DESIGN: Prospective blinded study. SETTING: Tertiary care cancer center. SUBJECTS AND METHODS: Informed consent was obtained and data collected from 52 consecutive previously untreated patients with HNSCC and clinical evidence of cervical metastasis. All patients underwent conventional evaluation for HNSCC and whole body PET/CT. Data were evaluated by 5 independent reviewers, who performed TNM staging per the American Joint Committee on Cancer (seventh edition) manual and proposed a treatment plan prior to viewing, and after reviewing, PET/CT. Cases where at least 3 of 5 reviewers agreed were considered significant. RESULTS: There were 0 patients for whom review of the PET/CT altered the T-class assessment (95% CI, 0-6.8), 12 (23.1%) for whom PET/CT altered N classification (95% CI, 12.5-34.5), and 2 (3.8%) for whom PET/CT altered the M classification (95% CI, 0.5-13.2). For 5 patients (9.6%), overall stage was altered per PET/CT review (95% CI, 3.2-21). For 3 patients (5.8%), PET/CT findings prompted reviewers to alter treatment recommendations (95% CI, 1.2-15.9). CONCLUSION: When added to more conventional patient evaluation, PET/CT results in changes to the TNM categories, but overall staging and treatment were less frequently affected. Whether PET/CT should be used routinely for patients with stage III and IV HNSCC is still subjective and merits further study.
OBJECTIVE: To understand the effects of positron emission tomography/computed tomography (PET/CT) evaluation on patients with previously untreated head and neck squamous cell carcinoma (HNSCC) with clinical evidence of regional lymph node involvement. STUDY DESIGN: Prospective blinded study. SETTING: Tertiary care cancer center. SUBJECTS AND METHODS: Informed consent was obtained and data collected from 52 consecutive previously untreated patients with HNSCC and clinical evidence of cervical metastasis. All patients underwent conventional evaluation for HNSCC and whole body PET/CT. Data were evaluated by 5 independent reviewers, who performed TNM staging per the American Joint Committee on Cancer (seventh edition) manual and proposed a treatment plan prior to viewing, and after reviewing, PET/CT. Cases where at least 3 of 5 reviewers agreed were considered significant. RESULTS: There were 0 patients for whom review of the PET/CT altered the T-class assessment (95% CI, 0-6.8), 12 (23.1%) for whom PET/CT altered N classification (95% CI, 12.5-34.5), and 2 (3.8%) for whom PET/CT altered the M classification (95% CI, 0.5-13.2). For 5 patients (9.6%), overall stage was altered per PET/CT review (95% CI, 3.2-21). For 3 patients (5.8%), PET/CT findings prompted reviewers to alter treatment recommendations (95% CI, 1.2-15.9). CONCLUSION: When added to more conventional patient evaluation, PET/CT results in changes to the TNM categories, but overall staging and treatment were less frequently affected. Whether PET/CT should be used routinely for patients with stage III and IV HNSCC is still subjective and merits further study.
Authors: Yukako Ichimiya; Krishna Alluri; Charles Marcus; Simon Best; Christine H Chung; Rathan M Subramaniam Journal: Am J Nucl Med Mol Imaging Date: 2015-01-15
Authors: Mark K Wax; Larry L Myers; Edward C Gabalski; Syed Husain; Jayakumari M Gona; Hani Nabi Journal: Arch Otolaryngol Head Neck Surg Date: 2002-06
Authors: Jos M J A A Straetmans; Nadine Olthof; Jeroen J Mooren; Jos de Jong; Ernst-Jan M Speel; Bernd Kremer Journal: Laryngoscope Date: 2009-10 Impact factor: 3.325
Authors: Fernando García-Curdi; Yolanda Lois-Ortega; Ana Muniesa-Del Campo; Amaranta McGee-Laso; José Miguel Sebastián-Cortés; Héctor Vallés-Varela; Julio José Lambea-Sorrosal Journal: Braz J Otorhinolaryngol Date: 2019-07-06