Distant metastases and synchronous malignancies on FDG-PET/CT in patients with head and neck cancer: a retrospective study
Distant metastases and synchronous malignancies on FDG-PET/CT in patients with head and neck cancer: a retrospective study
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DOI：
10.1177/0284185119896344
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发表时间：
2020-01-05
期刊：
影响因子：
1.3
通讯作者：
Mo, Susanna Jakobson
中科院分区：
文献类型：
--
作者：
Flygare, Lennart;Al-Ubaedi, Amal;Mo, Susanna Jakobson
背景：氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）已被证明是检测头颈部癌（HNC）远处转移的良好方法。然而，大多数之前的研究都是基于亚洲人群，可能无法直接转移到西方人群。目的研究瑞典北方人群HNC中PET/CT检测到的远处转移和同步恶性肿瘤的频率和分布。材料和方法回顾性分析了2013年1月1日至2016年12月31日在瑞典Umea大学医院进行的所有怀疑HNC的初步全身FDG-PET/CT检查（n = 524例患者）。排除189例无原发性HNC证据的检查后，分析了335例检查。结果10例（3%）患者发生远处转移，均为TNM分期3-4的晚期原发肿瘤，以涎腺腺癌最多见，其中50%的患者发生远处转移。四名患者有转移到膈下，占20%的唾液腺恶性肿瘤。在其余6例患者中，转移灶位于膈上，除1例外，其余均仅通过CT确定。在14例（4.2%）患者中发现了同步恶性肿瘤，其中5例发生在膈下。结论原发性HNC的远处转移和同时发生恶性肿瘤的发生率普遍较低。然而，在唾液腺腺癌中，膈下远处转移的风险相对较高，支持在这些患者的主要诊断检查中使用全身FDG-PET/CT。
Background Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been proven to be a good method to detect distant spread of head and neck cancer (HNC). However, most prior studies are based on Asian populations and may not be directly transferable to western populations. Purpose To investigate the frequency and distribution of distant metastases and synchronous malignancies detected by PET/CT in HNC in a northern Swedish population. Material and Methods All primary whole-body FDG-PET/CT examinations performed on the suspicion of HNC (n = 524 patients) between 1 January 2013 and 31 December 2016 at Umea University Hospital in Sweden were retrospectively reviewed . After the exclusion of 189 examinations without evidence of primary HNC, 335 examinations were analyzed. Results Distant metastases were detected in 10 (3%) patients, all with advanced primary tumors corresponding to TNM stage 3-4, most frequently in salivary gland adenocarcinoma, where 50% of patients had distant spread. Four patients had metastases below the diaphragm, representing 20% of the salivary gland malignancies. In the remaining six patients, metastases were supraphrenic, of which all but one were identified by CT alone. Synchronous malignancies were discovered in 14 (4.2%) patients, of which five were below the diaphragm. Conclusion The overall frequency of distant spread and synchronous malignancy in primary HNC was generally low. However, the risk for distant metastases below the diaphragm was relatively higher in salivary gland adenocarcinoma, supporting whole-body FDG-PET/CT in the primary diagnostic work-up in these patients.