Comorbidity assessment in patients with oral squamous cell carcinoma: can imaging techniques (18FDG PET/CT and contrast - enhanced CT) provide additional information?

Publication date: Available online 31 May 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Matthias Troeltzsch, Florian Andreas Probst, Axel Rominger, Ulrich Müller - Lisse, Monika Probst, Katharina Obermeier, Michael Ehrenfeld, Sven Otto
PurposeTo evaluate the role of imaging staging examinations (PET/CT and contrast - enhanced [ce]CT) for the assessment of the comorbidity status of patients with oral squamous cell carcinoma (OSCC). A binary null hypothesis was drafted: (1) imaging staging examinations do not augment knowledge about the comorbidity status of OSCC patients and (2) there is no difference between PET/CT and ceCT in this matter.MethodsA retrospective cohort study design was selected to address the research question. Patients with histologically confirmed OSCC who underwent whole - body staging either by PET/CT or ceCT between 2012 and 2015 were considered for inclusion with respect to predefined criteria. The data collection was performed by review of patient charts, histology, radiology and nuclear medicine reports. The Charlson Comorbidity Index (CCI) was chosen to quantify comorbidity and was calculated before and after staging and then compared. The type of the imaging staging examination (PET/CT or ceCT) served as the predictor variable and the CCI was determined as the primary outcome variable. Descriptive and inferential statistics were computed with respect to the variable scale. The significance level was set at p ≤ 0.05.ResultsThe sample was composed of 178 patients (female: 71, male: 107; average age 64.2) of whom 109 (61%) underwent PET/CT and 69 (39%) ceCT staging. The pre - and post - staging CCI differed significantly. Neither of the imaging techniques showed superior results.ConclusionRelevant and otherwise covert comorbidity can be revealed by the performance imaging staging examinations. This enables clinicians to better assess the peritherapeutic risk and prognosis of OSCC patients. A detailed evaluation of incidental findings in imaging studies is therefore warranted and recommended.



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