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

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.