FDG-PET/CT predicts survival and lung metastasis of hypopharyngeal cancer in a multi-institutional retrospective study

Objectives We investigated a possible correlation between the maximum standardized uptake value (SUVmax), which is assessed by pretreatment F-18-fluorodeoxyglucose positron emission tomography with computed tomography, and the overall survival (OS) in patients with hypopharyngeal squamous cell carcinoma from two institutions on longterm follow-up, and examined whether SUVmax is correlated with several survival outcomes, including lung metastasis-free survival. Methods A total of 81 patients were enrolled. The survival rate was calculated by the Kaplan-Meier method. Both univariate and multivariate survival analyses were assessed by a Cox proportional hazards model. Results SUVmax >= 15.2 in institution A (p = 0.0306) or SUVmax >= 8 in institution B (p = 0.0132) was significantly predictor of a lower OS. We disaggregated the data by high SUVmax (SUVmax >= 15.2 from institution A and SUVmax >= 8 from institution B) and low SUVmax (SUVmax<15.2 from institution A and SUVmax <8 from institution B). Patients with a high SUVmax exhibited a significantly lower OS in both univariate (p = 0.001) and multivariate (p = 0.0046) analyses for adjusted for the clinical stage and treatment group. The patients with a high SUVmax exhibited significantly shorter disease-specific (p = 0.0068), distant metastasis-free (p = 0.0428), and lung metastasis-free (p = 0.0328) survivals. Conclusions High SUVmax was significantly correlated with a lower OS, disease-specific survival, distant metastasis- free survival, and lung metastasis-free survival in a multi-institutional retrospective study.