Prediction of Disease-Free Survival in Patients with Squamous Cell Carcinomas of the Head and Neck Using Dynamic Contrast-Enhanced MR Imaging

BACKGROUND AND PURPOSE: Patients with HNSCC have a poor prognosis and development of imaging biomarkers that predict long-term outcome might aid in planning optimal treatment strategies. Therefore, the purpose of the present study was to predict disease-free survival in patients with HNSCC by using pretreatment K^trans measured from dynamic contrast-enhanced MR imaging.

MATERIALS AND METHODS: Sixty-six patients with HNSCC were recruited from January 2005 to October 2008. Three patients were excluded because they underwent upfront neck dissection, and 6 patients were excluded due to suboptimal MR imaging data or being lost to follow-up. Disease-free survival was measured in the remaining 57 patients from the end date of chemoradiation therapy. In patients who died, the end point was the date of death, while in surviving patients the date of last clinical follow-up was used as the end point. Pretreatment K^trans and nodal volume were computed from the largest metastatic node, and median pretreatment K^trans and volume were used to divide patients into 2 groups (at or above the threshold value [group I] and below the threshold value [group II]. Disease-free survival was analyzed by the Kaplan-Meier method, and the results were compared by using a logrank test with K^trans and nodal volume as predictors. A P value < .05 was considered significant.

RESULTS: Thirteen of 57 patients had died of HNSCC by the last follow-up period (March 31, 2009). Patients with higher pretreatment K^trans values had prolonged disease-free survival compared with patients with lower K^trans values (P = .029). However, there was no significant difference in disease-free survival when nodal volume was used as a predictor (P = .599).

CONCLUSIONS: Pretreatment K^trans may be a useful prognostic marker in HNSCC.