Prognostic value of metabolic tumor volume measured by 18F-FDG PET/CT in advanced-stage squamous cell carcinoma of the larynx and hypopharynx

Metabolic tumor volume (MTV) of F-18-FDG PET/CT is a volumetric measurement of tumor cells with increased F-18-FDG uptake. We evaluated the prognostic value of MTV in patients with locoregionally advanced laryngeal and hypopharyngeal cancer. We evaluated 81 patients with advanced-stage squamous cell carcinoma of the laryngohypopharynx who underwent F-18-FDG PET/CT between January 2004 and September 2009. Clinicopathologic factors and MTV were analyzed for their association with locoregional control (LRC) and overall survival (OS). The 3-year LRC and OS for all patients were 70.9 and 78.7%, respectively, with a median follow-up of 40.4 months (range 24.5-90.1). In univariate analyses, MTV, primary site, and primary treatment strategy were associated with both LRC and OS (P < 0.05). On multivariate analysis, MTV was an independent prognostic factor for both LRC [P = 0.018; HR = 3.141, 95% confidence interval (CI) = 1.175-8.399] and OS (P = 0.008; HR = 3.758, 95% CI = 1.415-9.982). Primary site was also a significant prognostic factor for LRC (P = 0.047). Pretreatment MTV is an independent prognostic factor in patients with locoregionally advanced squamous cell carcinoma of the larynx and hypopharynx.