Visceral adipose tissue volume and CT-attenuation as prognostic factors in patients with head and neck cancer

Head Neck. 2019 Jun;41(6):1605-1614. doi: 10.1002/hed.25605. Epub 2019 Jan 12.

Abstract

Background: The aim of this study was to evaluate the relationship of the characteristics of subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) to the disease progression-free survival and distant failure-free survival of head and neck squamous cell carcinoma (HNSCC).

Methods: We enrolled 152 HNSCC patients who underwent staging 18 F-fluorodeoxyglucose (FDG) positron emission tomography/CT (PET/CT). Maximum FDG uptake (standardized uptake value [SUV]) and total lesion glycolysis (TLG) of the primary tumor and volume, CT-attenuation (Hounsfield units [HU]), and FDG uptake of SAT and VAT were measured. Survival analysis using Cox proportional hazard modeling was performed to assess the relationship between the adipose tissue parameters of PET/CT and survival.

Results: Patients with low VAT volume and high VAT HU had significantly worse progression-free survival and distant failure-free survival than those with high VAT volume and low VAT HU. On multivariate analysis, the volume and HU of VAT were significantly correlated with disease progression-free survival and distant failure-free survival after adjusting for age, sex, body mass index, TNM stage, serum C-reactive protein, maximum SUV, and TLG.

Conclusion: The volume and CT-attenuation of VAT were significantly correlated with disease progression-free survival and distant failure-free survival in patients with HNSCC.

Keywords: adipose tissue; fluorodeoxyglucose F18; head and neck cancer; positron emission tomography; prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fluorodeoxyglucose F18
  • Head and Neck Neoplasms / mortality*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Intra-Abdominal Fat / diagnostic imaging*
  • Male
  • Middle Aged
  • Positron Emission Tomography Computed Tomography*
  • Prognosis
  • Progression-Free Survival
  • Radiopharmaceuticals
  • Retrospective Studies
  • Survival Analysis
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18