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Poster Display session 3

3517 - Role of follow-up (FU) FDG-PET/CT (FU-FDG-PET/CT) in patients with locoregionally advanced squamous cell carcinoma of the head and neck (LA-HNSCC) treated with chemotherapy and radiotherapy (RT), either concurrent (CRT) or sequential (ST).


30 Sep 2019


Poster Display session 3


Tumour Site

Head and Neck Cancers


Bert Van Den Heuvel


Annals of Oncology (2019) 30 (suppl_5): v449-v474. 10.1093/annonc/mdz252


B. Van Den Heuvel1, C. Van Laer2, P.M.C. Specenier1

Author affiliations

  • 1 Oncology, University Hospital Antwerp, 2650 - Edegem/BE
  • 2 Otolaryngology, University Hospital Antwerp, 2650 - Edegem/BE


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Abstract 3517


The role of FDG-PET/CT in the FU of LA-HNSCC is unclear.


Scan reports of LA-HNSCC patients, having FU-FDG-PET/CT performed 6-18 months after ST/CRT were retrospectively analyzed. Equivocal reports were scored as positive. Excluded were patients with proven recurrence before FU-FDG-PET/CT. The reference standard was the occurrence of a second primary (SP) or a recurrence < 12 months after FU-FDG-PET/CT. Primary endpoints included sensitivity, specificity, positive (PPV) and negative predictive value (NPV) on a patient level.


We identified 73 patients. Primary tumor site: oropharynx: n = 35; 7 larynx: n = 7; hypopharynx: n = 11; oral cavity: n = 4; paranasal sinus: n = 4; unknown: n = 5. Tumor stage (UICC 7): II (T2N0): n = 1; III: n = 9; IV: n = 63. T1: n = 8; T2: n = 20; T3: n = 16; T4: n = 24. N0: n = 10; N1: n = 7; N2: n = 53; N3: n = 2. Patients were treated by CRT (n = 29) or ST (n = 44). A prior FDG-PET/CT at 3 months after end of treatment (EOT) (EOT-FDG-PET/CT) had been performed in 69/73 (60 negative, 6 false and 3 true positive [resected lymph nodes]). FU-FDG-PET/CT in patients without EOT-FDG-PET/CT was true negative in 3 patients and true positive in 1. Median time between EOT and FU-FDG-PET/CT was 12 months (range 6-17). Median FU after FU-FDG-PET/CT was 48 months (range 2-130). Sensitivity, specificity, PPV and NPV were 83% (95% CI 52-98), 87% (95% CI 76-94), 56% (95% CI 31-78) and 96% (95% CI 87-100), respectively. Local recurrences, SP and distant metastases were detected in 5, 1, and 4 patients, respectively. One FU-FDG-PET/CT-detected local recurrence and 1 SP were treated with curative intent. All false-positive patients (n = 8) underwent biopsy (n = 3) or surgery (n = 5). 15 patients (21%) recurred > 12 months after FU-FDG-PET-CT. Median overall survival was 49 (95% CI 29 - 68) and 98 months (95% CI 86-111) in FU-FDG-PET/CT-positive and -negative patients, respectively (p = 0.000196).


FU-FDG-PET/CT in real-life has a high NPV and significant prognostic value. However, false-positive scans induce invasive procedures in a significant fraction of patients.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.


Has not received any funding.


All authors have declared no conflicts of interest.

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