Pretreatment ADC is not a prognostic factor for local recurrences in head and neck squamous cell carcinoma when clinical T-stage is known

Boris Peltenburg; Juliette P Driessen; Jeanine E Vasmel; Frank A Pameijer; Luuk M Janssen; Chris H J Terhaard; Remco de Bree; Marielle E P Philippens

doi:10.1007/s00330-019-06426-y

Pretreatment ADC is not a prognostic factor for local recurrences in head and neck squamous cell carcinoma when clinical T-stage is known

Boris Peltenburg
, Juliette P Driessen
, Jeanine E Vasmel
, Frank A Pameijer
, Luuk M Janssen
, Chris H J Terhaard
, Remco de Bree
, Marielle E P Philippens

Research output: Contribution to journal › Article › Academic › peer-review

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Abstract

OBJECTIVES: Pretreatment identification of radio-insensitive head and neck squamous cell carcinomas (HNSCC) would affect treatment modality selection. The apparent diffusion coefficient (ADC) of a tumor could be a predictor of local recurrence. However, little is known about its prognostic value next to known factors such as clinical T-stage. The aim of the present study is to determine the added value of pretreatment ADC to clinical T-stage as a prognostic factor for local recurrence.

METHODS: This retrospective cohort study included 217 patients with HNSCC treated with (chemo)radiotherapy between April 2009 and December 2015. All patients underwent diffusion-weighted MRI prior to treatment. Median ADC values of all tumors were obtained using a semi-automatic delineation method. Univariate models containing ADC and T-stage were compared with a multivariable model containing both variables.

RESULTS: Fifty-eight patients experienced a local recurrence within 3 years. On average, the ADC value in the group of patients with a recurrence was 1.01 versus 1.00 (10-3 mm2/s) in the group without a recurrence. Univariate analysis showed no significant association between tumor ADC and local recurrence within 3 years after (chemo)radiotherapy (p = 0.09). Cox regression showed that clinical T-stage was an independent predictor of local recurrence and adding ADC to the model did not increase its performance.

CONCLUSION: Pretreatment ADC has no added value as a prognostic factor for local recurrence to clinical T-stage.

KEY POINTS: • Pretreatment identification of head and neck squamous cell carcinoma patients who do not benefit from (chemo)radiotherapy could improve personalized cancer care. • The apparent diffusion coefficient (ADC) obtained from diffusion-weighted MRI has been reported to be a prognostic factor for local recurrence. • In this study, ADC has no added value as a prognostic factor compared with clinical T-stage.

Original language	English
Pages (from-to)	1228-1231
Number of pages	4
Journal	European Radiology
Volume	30
Issue number	2
DOIs	https://doi.org/10.1007/s00330-019-06426-y
Publication status	Published - 1 Feb 2020

Keywords

(Chemo)radiotherapy
Diffusion magnetic resonance imaging
Disease-free survival
Head and neck neoplasms
Neoplasm recurrence, local

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@article{15771814857840f390c1d3075bbb618d,

title = "Pretreatment ADC is not a prognostic factor for local recurrences in head and neck squamous cell carcinoma when clinical T-stage is known",

abstract = "OBJECTIVES: Pretreatment identification of radio-insensitive head and neck squamous cell carcinomas (HNSCC) would affect treatment modality selection. The apparent diffusion coefficient (ADC) of a tumor could be a predictor of local recurrence. However, little is known about its prognostic value next to known factors such as clinical T-stage. The aim of the present study is to determine the added value of pretreatment ADC to clinical T-stage as a prognostic factor for local recurrence.METHODS: This retrospective cohort study included 217 patients with HNSCC treated with (chemo)radiotherapy between April 2009 and December 2015. All patients underwent diffusion-weighted MRI prior to treatment. Median ADC values of all tumors were obtained using a semi-automatic delineation method. Univariate models containing ADC and T-stage were compared with a multivariable model containing both variables.RESULTS: Fifty-eight patients experienced a local recurrence within 3 years. On average, the ADC value in the group of patients with a recurrence was 1.01 versus 1.00 (10-3 mm2/s) in the group without a recurrence. Univariate analysis showed no significant association between tumor ADC and local recurrence within 3 years after (chemo)radiotherapy (p = 0.09). Cox regression showed that clinical T-stage was an independent predictor of local recurrence and adding ADC to the model did not increase its performance.CONCLUSION: Pretreatment ADC has no added value as a prognostic factor for local recurrence to clinical T-stage.KEY POINTS: • Pretreatment identification of head and neck squamous cell carcinoma patients who do not benefit from (chemo)radiotherapy could improve personalized cancer care. • The apparent diffusion coefficient (ADC) obtained from diffusion-weighted MRI has been reported to be a prognostic factor for local recurrence. • In this study, ADC has no added value as a prognostic factor compared with clinical T-stage.",

keywords = "(Chemo)radiotherapy, Diffusion magnetic resonance imaging, Disease-free survival, Head and neck neoplasms, Neoplasm recurrence, local",

author = "Boris Peltenburg and Driessen, \{Juliette P\} and Vasmel, \{Jeanine E\} and Pameijer, \{Frank A\} and Janssen, \{Luuk M\} and Terhaard, \{Chris H J\} and \{de Bree\}, Remco and Philippens, \{Marielle E P\}",

note = "Funding Information: We thank A.S. Borggreve for assistance with the statistical analysis. Publisher Copyright: {\textcopyright} 2019, The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.",

year = "2020",

month = feb,

day = "1",

doi = "10.1007/s00330-019-06426-y",

language = "English",

volume = "30",

pages = "1228--1231",

journal = "European Radiology",

issn = "0938-7994",

publisher = "Springer Science and Business Media Deutschland GmbH",

number = "2",

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TY - JOUR

T1 - Pretreatment ADC is not a prognostic factor for local recurrences in head and neck squamous cell carcinoma when clinical T-stage is known

AU - Peltenburg, Boris

AU - Driessen, Juliette P

AU - Vasmel, Jeanine E

AU - Pameijer, Frank A

AU - Janssen, Luuk M

AU - Terhaard, Chris H J

AU - de Bree, Remco

AU - Philippens, Marielle E P

N1 - Funding Information: We thank A.S. Borggreve for assistance with the statistical analysis. Publisher Copyright: © 2019, The Author(s). Copyright: Copyright 2020 Elsevier B.V., All rights reserved.

PY - 2020/2/1

Y1 - 2020/2/1

N2 - OBJECTIVES: Pretreatment identification of radio-insensitive head and neck squamous cell carcinomas (HNSCC) would affect treatment modality selection. The apparent diffusion coefficient (ADC) of a tumor could be a predictor of local recurrence. However, little is known about its prognostic value next to known factors such as clinical T-stage. The aim of the present study is to determine the added value of pretreatment ADC to clinical T-stage as a prognostic factor for local recurrence.METHODS: This retrospective cohort study included 217 patients with HNSCC treated with (chemo)radiotherapy between April 2009 and December 2015. All patients underwent diffusion-weighted MRI prior to treatment. Median ADC values of all tumors were obtained using a semi-automatic delineation method. Univariate models containing ADC and T-stage were compared with a multivariable model containing both variables.RESULTS: Fifty-eight patients experienced a local recurrence within 3 years. On average, the ADC value in the group of patients with a recurrence was 1.01 versus 1.00 (10-3 mm2/s) in the group without a recurrence. Univariate analysis showed no significant association between tumor ADC and local recurrence within 3 years after (chemo)radiotherapy (p = 0.09). Cox regression showed that clinical T-stage was an independent predictor of local recurrence and adding ADC to the model did not increase its performance.CONCLUSION: Pretreatment ADC has no added value as a prognostic factor for local recurrence to clinical T-stage.KEY POINTS: • Pretreatment identification of head and neck squamous cell carcinoma patients who do not benefit from (chemo)radiotherapy could improve personalized cancer care. • The apparent diffusion coefficient (ADC) obtained from diffusion-weighted MRI has been reported to be a prognostic factor for local recurrence. • In this study, ADC has no added value as a prognostic factor compared with clinical T-stage.

AB - OBJECTIVES: Pretreatment identification of radio-insensitive head and neck squamous cell carcinomas (HNSCC) would affect treatment modality selection. The apparent diffusion coefficient (ADC) of a tumor could be a predictor of local recurrence. However, little is known about its prognostic value next to known factors such as clinical T-stage. The aim of the present study is to determine the added value of pretreatment ADC to clinical T-stage as a prognostic factor for local recurrence.METHODS: This retrospective cohort study included 217 patients with HNSCC treated with (chemo)radiotherapy between April 2009 and December 2015. All patients underwent diffusion-weighted MRI prior to treatment. Median ADC values of all tumors were obtained using a semi-automatic delineation method. Univariate models containing ADC and T-stage were compared with a multivariable model containing both variables.RESULTS: Fifty-eight patients experienced a local recurrence within 3 years. On average, the ADC value in the group of patients with a recurrence was 1.01 versus 1.00 (10-3 mm2/s) in the group without a recurrence. Univariate analysis showed no significant association between tumor ADC and local recurrence within 3 years after (chemo)radiotherapy (p = 0.09). Cox regression showed that clinical T-stage was an independent predictor of local recurrence and adding ADC to the model did not increase its performance.CONCLUSION: Pretreatment ADC has no added value as a prognostic factor for local recurrence to clinical T-stage.KEY POINTS: • Pretreatment identification of head and neck squamous cell carcinoma patients who do not benefit from (chemo)radiotherapy could improve personalized cancer care. • The apparent diffusion coefficient (ADC) obtained from diffusion-weighted MRI has been reported to be a prognostic factor for local recurrence. • In this study, ADC has no added value as a prognostic factor compared with clinical T-stage.

KW - (Chemo)radiotherapy

KW - Diffusion magnetic resonance imaging

KW - Disease-free survival

KW - Head and neck neoplasms

KW - Neoplasm recurrence, local

UR - https://www.scopus.com/pages/publications/85073823413

U2 - 10.1007/s00330-019-06426-y

DO - 10.1007/s00330-019-06426-y

M3 - Article

C2 - 31529258

SN - 0938-7994

VL - 30

SP - 1228

EP - 1231

JO - European Radiology

JF - European Radiology

IS - 2

ER -

Pretreatment ADC is not a prognostic factor for local recurrences in head and neck squamous cell carcinoma when clinical T-stage is known

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Keywords

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