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18F-FDG-PET/CT versus panendoscopy for the detection of synchronous second primary tumors in patients with head and neck squamous cell carcinoma

✍ Scribed by Stephan K. Haerle; Klaus Strobel; Thomas F. Hany; Daniel Sidler; Sandro J. Stoeckli

Publisher
John Wiley and Sons
Year
2009
Tongue
English
Weight
125 KB
Volume
32
Category
Article
ISSN
1043-3074

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✦ Synopsis

Abstract

Background.

This study assesses the additional value of ^18^F‐fluoro‐2‐deoxy‐D‐glucose positron emission tomography/CT (^18^F‐FDG‐PET/CT) with respect to synchronous primaries in patients undergoing panendoscopy for staging of head and neck squamous cell carcinoma.

Methods.

In all, 311 patients underwent both modalities. Cytology, histology, and/or clinical/imaging follow‐up served as reference standard.

Results.

The prevalence of second primary tumors detected by panendoscopy was 4.5%, compared with 6.1% detected by ^18^F‐FDG‐PET/CT. The sensitivity for panendoscopy was 74%, the specificity was 99.7%, the positive predictive value (PPV) was 93%, and the negative predictive value (NPV) was 98%. The sensitivity for ^18^F‐FDG‐PET/CT was 100%, the specificity was 95.7%, the PPV was 59%, and the NPV was 100%.

Conclusions.

^18^F‐FDG‐PET/CT is superior to panendoscopy. With a negative ^18^F‐FDG‐PET/CT, the extent of endoscopy can be reduced to the area of the primary tumor. Due to the costs, ^18^F‐FDG‐PET/CT is recommended only in advanced disease to assess potential distant disease. In early‐stage cancer, panendoscopy is accurate enough to rule out secondary tumors. © 2009 Wiley Periodicals, Inc. Head Neck, 2010

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