PET may artificially boost HNC survival rates
Source: www.drbicuspid.com Author: Donna Domino, Features Editor The use of positron emission tomography (PET) is associated with a stage migration phenomenon in locally advanced head and neck cancer (HNC) patients, according to a recent report in JAMA Otolaryngology -- Head & Neck Surgery. Multiple studies have shown the increased sensitivity of fluorodeoxyglucose (FDG)-PET over computed tomography (CT) for detecting primary tumors, regional nodal disease, and distant metastases. Because of potential treatment changes and prognostic information, as well as patient and physician preference, FDG-PET has been rapidly adopted for managing head and neck cancers. Because FDG-PET is more sensitive than CT, it often leads to patients being assigned a higher stage than if they were staged with CT alone, the study authors noted. In this retrospective study, the researchers sought to confirm whether the increased use of FDG-PET over time is associated with the appearance of improved stage-specific survival due to stage migration (JAMA Otolaryngol Head Neck Surg, July 1, 2014, Vol. 140:7, pp. 654-661). Results In the study's model of clinically important variables, PET scan use was associated with a higher stage of disease. In addition, oropharyngeal cancers were more likely to be assigned a higher stage than oral cavity cancers. Within the PET era, no statistically significant survival difference was found between those who underwent FDG-PET and those who did not. However, a significant increase in stage-specific survival was detected for patients with locally advanced disease. No stage-specific survival differences were found in patients with local disease or metastatic [...]