Pretreatment tumor standardized uptake value as a prognostic factor in primary head and neck squamous cell carcinoma

Our objective was to conduct a systematic review and meta-analysis of studies assessing the diagnostic performance of primary tumor standardized uptake value (SUV) in head and neck squamous cell carcinoma (HNSCC), as measured by positron emission tomography. A systematic search of the indexed medical literature was conducted using appropriate keywords to identify relevant studies. Six articles were identified by searching electronic databases. A statistical analysis was performed with RevMan 4.2.2 software. SUV measurement and the SUV threshold for defining high SUV were studied dependently. For each publication, we first obtained an estimate of the relative risk (RR) for comparing patients with a low and those with a high SUV. Subsequently, we aggregated the individual RRs into a combined RR using the fixed-effects model to yield weighted mean pooled estimates with 95% confidence intervals (CIs). Publication bias was assessed with a funnel plot. A total of 6 clinical trials involving 453 patients were included in the meta-analysis. The combined RR from the 6 reports for local control was 0.72 (95% CI: 0.63-0.81). The funnel plot revealed symmetrical distribution, indicating no evidence of significant publication bias. The increase in the SUV of the primary tumor was found to be a poor prognostic marker for patients with HNSCC in the meta-analysis, which requires further confirmation in a meta-analysis based on individual patient data.