Prognostic value of 18F-fludeoxyglucose uptake in 287 patients with head and neck squamous cell carcinoma.

BACKGROUND The prognostic value of 18F-Fludeoxyglucose (FDG) uptake could be due to its association with already known clinical risk factors. METHODS Correlation between FDG uptake metrics and other known risk factors from 287 patients were analyzed. Time to any failure was analyzed using Cox proportional hazards model stratified by tumor subsite. The resulting multivariate prognostic model was used to generate a table of 2-year freedom from failure estimates with confidence intervals (CIs). RESULTS Increasing values of standardized uptake value maximum (SUVmax) correlated with other known risk factors. The reduced Cox model included SUVmax (hazard ratio [HR] = 1.34), cisplatin (HR = 0.37), smoking status (HR = 1.49), and gross target volume (GTV; HR = 1.74) as significant prognostic factors. Including SUVmax in the model changed the 2-year failure estimate by more than 10% for a quarter of the patients (23%). CONCLUSION FDG uptake retains statistical significance in a multivariate analysis and has clinically relevant prognostic impact. We developed a prognostic model for risk stratification of patients in a clinical setting.