TY  - JOUR
AU  - Zschaeck, Sebastian
AU  - Hajiyianni, Marina
AU  - Hausmann, Patrick
AU  - Nikulin, Pavel
AU  - Kukuk, Emily
AU  - Furth, Christian
AU  - Cegla, Paulina
AU  - Lombardo, Elia
AU  - Kazmierska, Joanna
AU  - Holzgreve, Adrien
AU  - Strouthos, Iosif
AU  - Stromberger, Carmen
AU  - Belka, Claus
AU  - Baumann, Michael
AU  - Krause, Mechthild
AU  - Landry, Guillaume
AU  - Cholewinski, Witold
AU  - Kotzerke, Jorg
AU  - Zips, Daniel
AU  - van den Hoff, Jörg
AU  - Hofheinz, Frank
TI  - Total lesion glycolysis of primary tumor and lymphnodes is a strong predictor for development of distant metastases in oropharyngeal carcinoma patients with independent validation in automatically delineated lesions.
JO  - Cancer imaging
VL  - 25
IS  - 1
SN  - 1470-7330
CY  - London
PB  - BioMed Central
M1  - DKFZ-2025-00422
SP  - 18
PY  - 2025
AB  - Oropharyngeal carcinomas are characterized by an increasing incidence and a relatively good prognosis. Nonetheless, a considerable number of patients develops metachronous distant metastases; identification of these patients is an urgent medical need.This is a retrospective multicenter evaluation of 431 patients. All patients underwent [18F]-FDG positron emission tomography (PET). The cohort was split into an explorative group (n = 366) and a validation group (n = 65). Lesions were manually delineated in the explorative group and automatically delineated by a convolutional neuronal network (CNN) in the validation group. Quantitative PET parameters standardized uptake value (SUV), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were calculated for primary tumors (prim) and tumor plus lymphnodes (all). Association of parameters with freedom from distant metastases (FFDM) and overall survival (OS) was tested by cox regression analyses.In the explorative group, univariate analyses revealed an association of metric MTVprim (p = 0.022), MTVall (p < 0.001) and TLGall (p < 0.001) with FFDM, binarized parameters were also associated with FFDM (p < 0.001 and p = 0.002). Bootstrap analyses revealed a significantly better association of TLGall compared to TLGprim with FFDM (p = 0.02). MTVall and TLGall remained significantly associated with FFDM upon multivariate testing (p = 0.002, p = 0.031, respectively). In the validation group, the cutoff value for TLGall but not for TLGprim was significantly associated with FFDM (HR = 3.1, p = 0.045). Additional analyses with manually delineated contours of the validation cohort revealed a similar effect (HR = 3.47, p = 0.026). No considerable differences between HPV positive and negative disease were observed.TLGall is a promising biomarker to select OPC patients with high risk for metachronous distant metastases.
KW  - Humans
KW  - Oropharyngeal Neoplasms: pathology
KW  - Oropharyngeal Neoplasms: diagnostic imaging
KW  - Oropharyngeal Neoplasms: mortality
KW  - Oropharyngeal Neoplasms: metabolism
KW  - Male
KW  - Female
KW  - Retrospective Studies
KW  - Middle Aged
KW  - Glycolysis
KW  - Aged
KW  - Fluorodeoxyglucose F18
KW  - Positron-Emission Tomography: methods
KW  - Radiopharmaceuticals
KW  - Prognosis
KW  - Lymphatic Metastasis: diagnostic imaging
KW  - Lymph Nodes: pathology
KW  - Lymph Nodes: diagnostic imaging
KW  - Adult
KW  - Aged, 80 and over
KW  - Neoplasm Metastasis
KW  - Tumor Burden
KW  - Fluorodeoxyglucose positron emission tomography (Other)
KW  - Head and neck squamous cell carcinoma (Other)
KW  - Oropharynx cancer (Other)
KW  - Total lesion glycolysis (Other)
KW  - Fluorodeoxyglucose F18 (NLM Chemicals)
KW  - Radiopharmaceuticals (NLM Chemicals)
LB  - PUB:(DE-HGF)16
C6  - pmid:39985091
C2  - pmc:PMC11844016
DO  - DOI:10.1186/s40644-025-00836-6
UR  - https://inrepo02.dkfz.de/record/299012
ER  -