TY - JOUR
T1 - FDG-PET/CT and Pathology in Newly Diagnosed Head and Neck Cancer
T2 - ACRIN 6685 Trial, FDG-PET/CT cN0
AU - Stack, Brendan C.
AU - Duan, Fenghai
AU - Subramaniam, Rathan M.
AU - Romanoff, Justin
AU - Sicks, Jo Rean D.
AU - Bartel, Twyla
AU - Chen, Chien
AU - Lowe, Val J.
N1 - Funding Information:
Funding source: National Cancer Institute through the grants U01 CA079778, U01 CA080098, CA180820, and CA180794.
Funding Information:
Leslie Norris, graphic design of Figures 2 to 4. We thank Gregory Sorensen, MD, PhD, for his role as chair of the American College of Radiology Imaging Network Neuroimaging Committee, under which this project was initiated, and Christopher S. Hollenbeak, PhD, for his assistance in the study design. This study was coordinated by the ECOG-ACRIN Cancer Research Group (Peter J. O’Dwyer, MD, and Mitchell D. Schnall, MD, PhD, group cochairs).
Publisher Copyright:
© American Academy of Otolaryngology–Head and Neck Surgery Foundation 2020.
PY - 2021/6
Y1 - 2021/6
N2 - Objective: FDG-PET/CT (fluorodeoxyglucose–positron emission tomography/computed tomography) is effective to assess for occult neck nodal disease. We report risks and patterns of nodal disease based on primary site and nodal level from data on the dissected cN0 per the results from ACRIN 6685. Study Design: Prospective nonrandomized enrollment included participants with first-time head and neck squamous cell carcinoma and at least 1 cN0 neck side to be dissected. Setting: Twenty-four ACRIN-certified centers internationally (American College of Radiology Imaging Network). Methods: A total of 287 participants were enrolled. Preoperative FDG-PET/CT findings were centrally reviewed and compared with pathology. Incidence, relative risk, pattern of lymph node involvement, and impact upon neck dissection were reported. Results: An overall 983 nodal levels were dissected (n = 261 necks, n = 203 participants). The highest percentages of ipsilateral positive nodes by primary location and nodal level were oral cavity (level I, 17/110, 15.5%), pharynx (level II, 6/30, 20.0%), and larynx (level VI, 1/3, 33.3%). Conclusion: Levels at greatest risk for nodal disease in cN0 in terms of ipsilateral neck dissection are level I (oral cavity), II (pharynx), and VI (larynx). These data should be considered when treating patients presenting with cN0. This is the first study to comprehensively report the incidence, location, and risk of metastases in cN0 in the FDG-PET/CT era.
AB - Objective: FDG-PET/CT (fluorodeoxyglucose–positron emission tomography/computed tomography) is effective to assess for occult neck nodal disease. We report risks and patterns of nodal disease based on primary site and nodal level from data on the dissected cN0 per the results from ACRIN 6685. Study Design: Prospective nonrandomized enrollment included participants with first-time head and neck squamous cell carcinoma and at least 1 cN0 neck side to be dissected. Setting: Twenty-four ACRIN-certified centers internationally (American College of Radiology Imaging Network). Methods: A total of 287 participants were enrolled. Preoperative FDG-PET/CT findings were centrally reviewed and compared with pathology. Incidence, relative risk, pattern of lymph node involvement, and impact upon neck dissection were reported. Results: An overall 983 nodal levels were dissected (n = 261 necks, n = 203 participants). The highest percentages of ipsilateral positive nodes by primary location and nodal level were oral cavity (level I, 17/110, 15.5%), pharynx (level II, 6/30, 20.0%), and larynx (level VI, 1/3, 33.3%). Conclusion: Levels at greatest risk for nodal disease in cN0 in terms of ipsilateral neck dissection are level I (oral cavity), II (pharynx), and VI (larynx). These data should be considered when treating patients presenting with cN0. This is the first study to comprehensively report the incidence, location, and risk of metastases in cN0 in the FDG-PET/CT era.
KW - 18FDG-PET/CT
KW - cN0
KW - elective
KW - head and neck squamous cell cancer
KW - neck dissection
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U2 - 10.1177/0194599820969104
DO - 10.1177/0194599820969104
M3 - Article
C2 - 33231504
AN - SCOPUS:85096528257
SN - 0194-5998
VL - 164
SP - 1230
EP - 1239
JO - Otolaryngology - Head and Neck Surgery (United States)
JF - Otolaryngology - Head and Neck Surgery (United States)
IS - 6
ER -