OPSCC

OPSCC predicts absolute and cause-specific recurrence risks in oropharyngeal squamous cell carcinoma from pretreatment FDG PET/CT uptake metrics and clinical variables.

Key Features:

• Data Integration: Incorporates pretreatment FDG PET/CT scans from patients treated with primary radiotherapy at Rigshospitalet (2010–2017) and includes T-stage, N-stage, p16 status, metabolic tumor volume, and FDG uptake in primary tumor and lymph nodes.
• Statistical Analysis: Uses four cause-specific Cox regression models to estimate hazard ratios for recurrence at T-, N-, and M-sites and for death with no evidence of disease (NED).
• Competing Risk Analysis: Employs the Aalen–Johansen method to generate absolute risk estimates in a competing risk framework.
• Prognostic Findings: Identifies high nodal FDG uptake as significantly associated with increased N- and M-site recurrence (HR 2.13, 95% CI 1.20–3.77; HR 2.18, 95% CI 1.16–4.10, respectively).

Scientific Applications:

• Prognostication in OPSCC: Provides data-driven absolute and cause-specific recurrence risk estimates for oropharyngeal squamous cell carcinoma.
• Risk Stratification: Enables identification of patients at higher risk of T-, N-, or M-site recurrence and of death NED based on FDG uptake and clinical variables.
• Biomarker Evaluation: Quantifies the prognostic impact of nodal FDG uptake and metabolic tumor volume as imaging biomarkers.
• Complement to Staging: Supplements UICC8 staging by integrating FDG PET/CT metrics into risk assessment.

Methodology:

Pretreatment FDG PET/CT data from patients treated with primary radiotherapy at Rigshospitalet (2010–2017), including T-stage, N-stage, p16 status, metabolic tumor volume, and FDG uptake in primary tumor and lymph nodes, were analyzed using four cause-specific Cox regression models to calculate hazard ratios for T-, N-, M-site recurrence and death NED, and absolute risks were estimated with the Aalen–Johansen method.