title: Prediction of surgical outcome using plasma Epstein-Barr virus dna and (18)F-FDG PET-CT scan in recurrent nasopharyngeal carcinoma.
abstract: BACKGROUND
  This study was carried out to determine the role of plasma Epstein-Barr virus (pEBV)-DNA and positron-emission tomography (PET)-CT scan in predicting the outcome of nasopharyngectomy and cervical lymphadenectomy for recurrent nasopharyngeal carcinoma (NPC).
  
  
  METHODS
  Between 2007 and 2009, we recruited patients who had local or regional recurrent NPC after radiotherapy. The relationship between preoperative pEBV-DNA level, maximal standard uptake value (SUVmax), and surgical outcome was analyzed.
  
  
  RESULTS
  Forty-two patients had local tumor recurrence. Their median pEBV-DNA level and SUVmax were 348 copies and 4.7, respectively. Both values were significantly lower than those with palliative nasopharyngectomy. Twenty-two patients had regional failure. Their mean pEBV-DNA level and tumor SUVmax were 626 copies and 7.6, respectively. The metastatic lymph nodes with extracapsular spread had a significantly higher mean SUVmax.
  
  
  CONCLUSIONS
  Preoperative pEBV-DNA and PET-CT predict the surgical outcome of nasopharyngectomy for recurrent NPC. Similarly, PET-CT scan predicts the presence of extracapsular spread of metastatic lymph nodes. These patients may warrant further postoperative adjuvant therapy.
authors.affiliation: Division of Head and Neck Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong SAR, China. chanjyw@gmail.com
authors.forename: Jimmy Yu Wai
authors.initials: JY
authors.lastname: Chan
authors.forename: Velda Ling Yu
authors.initials: VL
authors.lastname: Chow
authors.forename: Vivian Way Kay
authors.initials: VW
authors.lastname: Mok
authors.forename: Ambrose Chung Wai
authors.initials: AC
authors.lastname: Ho
authors.forename: William Ignace
authors.initials: WI
authors.lastname: Wei
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D004854:Herpesvirus 4, Human / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D009303:Nasopharyngeal Neoplasms / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery* / Q000821:virology; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000000981:diagnostic imaging* / Q000601:surgery* / Q000821:virology; D009367:Neoplasm Staging; D010611:Pharyngectomy / Q000379:methods; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D012189:Retrospective Studies; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D004279:DNA, Viral; D019788:Fluorodeoxyglucose F18