Staging of Head and Neck Squamous Cell Cancer with Extended-Field FDG-PET

David Schwartz, Joseph Rajendran, Bevan Yueh, Marc Coltrera, Yoshimi Anzai, Kenneth Krohn, Janet Eary

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Background: Accurate baseline staging is necessary to appropriately treat head and neck squamous cell carcinoma. [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) is valuable for locoregional staging of primary head and neck disease. The effectiveness of FDG-PET for the detection of distant metastatic or synchronous disease remains unproven. Objective: To investigate the utility of FDG-PET extended into the abdomen (extended-field FDG-PET) for wide-field staging of head and neck tumors. Methods: This is a prospective institutional study of 35 consecutive patients diagnosed with American Joint Committee on Cancer (AJCC)-defined stage II-IV squamous cell carcinoma of the oral cavity, oropharynx, or larynx between September 2000 and June 2002. Thirty-three patients (94%) were eligible for analysis. All patients were routinely staged with chest radiography, liver function tests, and extended-field FDG-PET. Chest or abdominal computed tomographic scans were used as corroborative studies and were obtained only when one of the above tests indicated distant disease. Results: Of 33 patients, 7 (21%) had evidence of distant disease by extend-field FDG-PET-4 with metastases and 3 with synchronous primary cancers of the aerodigestive tract. [F-18]-fluorodeoxyglucose PET detected hepatic, bone, gastrointestinal, and mediastinal disease not identified by chest radiography or liver function tests. Two of the 7 patients with FDG-avid distant disease had false-negative staging by all other tests, including computed tomography. Conclusions: Extended-field FDG-PET is feasible and may improve staging of primary head and neck squamous cell carcinoma. Use of staging FDG-PET must be explicitly described in reports from centers engaged in prospective research to facilitate comparison with historical results.

Original languageEnglish (US)
Pages (from-to)1173-1178
Number of pages6
JournalArchives of Otolaryngology - Head and Neck Surgery
Volume129
Issue number11
DOIs
StatePublished - Nov 1 2003

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Squamous Cell Neoplasms
Head and Neck Neoplasms
Positron-Emission Tomography
Head
Thorax
Liver Function Tests
Fluorodeoxyglucose F18
Radiography
Neck
Mediastinal Diseases
Neoplasms
Oropharynx
Gastrointestinal Diseases
Bone Diseases
Larynx
Abdomen
Mouth
Squamous Cell Carcinoma
Tomography
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Surgery
  • Otorhinolaryngology
  • Medicine(all)

Cite this

Staging of Head and Neck Squamous Cell Cancer with Extended-Field FDG-PET. / Schwartz, David; Rajendran, Joseph; Yueh, Bevan; Coltrera, Marc; Anzai, Yoshimi; Krohn, Kenneth; Eary, Janet.

In: Archives of Otolaryngology - Head and Neck Surgery, Vol. 129, No. 11, 01.11.2003, p. 1173-1178.

Research output: Contribution to journalArticle

Schwartz, David ; Rajendran, Joseph ; Yueh, Bevan ; Coltrera, Marc ; Anzai, Yoshimi ; Krohn, Kenneth ; Eary, Janet. / Staging of Head and Neck Squamous Cell Cancer with Extended-Field FDG-PET. In: Archives of Otolaryngology - Head and Neck Surgery. 2003 ; Vol. 129, No. 11. pp. 1173-1178.
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abstract = "Background: Accurate baseline staging is necessary to appropriately treat head and neck squamous cell carcinoma. [F-18]-fluorodeoxyglucose positron emission tomography (FDG-PET) is valuable for locoregional staging of primary head and neck disease. The effectiveness of FDG-PET for the detection of distant metastatic or synchronous disease remains unproven. Objective: To investigate the utility of FDG-PET extended into the abdomen (extended-field FDG-PET) for wide-field staging of head and neck tumors. Methods: This is a prospective institutional study of 35 consecutive patients diagnosed with American Joint Committee on Cancer (AJCC)-defined stage II-IV squamous cell carcinoma of the oral cavity, oropharynx, or larynx between September 2000 and June 2002. Thirty-three patients (94{\%}) were eligible for analysis. All patients were routinely staged with chest radiography, liver function tests, and extended-field FDG-PET. Chest or abdominal computed tomographic scans were used as corroborative studies and were obtained only when one of the above tests indicated distant disease. Results: Of 33 patients, 7 (21{\%}) had evidence of distant disease by extend-field FDG-PET-4 with metastases and 3 with synchronous primary cancers of the aerodigestive tract. [F-18]-fluorodeoxyglucose PET detected hepatic, bone, gastrointestinal, and mediastinal disease not identified by chest radiography or liver function tests. Two of the 7 patients with FDG-avid distant disease had false-negative staging by all other tests, including computed tomography. Conclusions: Extended-field FDG-PET is feasible and may improve staging of primary head and neck squamous cell carcinoma. Use of staging FDG-PET must be explicitly described in reports from centers engaged in prospective research to facilitate comparison with historical results.",
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AU - Krohn, Kenneth

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