biostudies-literatureUnknown9(4)Courtney PTNational Institutes of Health/National Center for Advancing Translational Science<h4>Background</h4>Residual or recurrent cancer after surgery but prior to adjuvant therapy occurs in a proportion of patients with head and neck cancer and may warrant treatment changes. 18-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) may help to identify residual or recurrent disease but is not routinely obtained. We evaluated the relevance of postoperative FDG-PET/CT in this clinical context.<h4>Methods</h4>This single-institution, retrospective study identified patients with head and neck cancer who underwent definitive surgery between January 1, 2013, and April 1, 2023, and received a postoperative FDG-PET/CT prior to adjuvant treatment. We measured the rates of management changes resulting from postoperative FDG-PET/CT findings and the association between having a postoperative FDG-PET/CT which resulted in a management change and oncologic outcomes with selected multivariable competing-risks and proportional hazards regressions.<h4>Results</h4>Of 150 patients, 66 (44.0%) had a management change because of the postoperative FDG-PET/CT findings; 62 (93.8%) had radiotherapy plan changes, 20 (30.3%) underwent additional diagnostic testing, 11 (16.7%) had systemic therapy added or changed, 3 (4.6%) underwent reresection, and 15 (10.0%) switched to palliative-intent treatment. Having a postoperative FDG-PET/CT that resulted in a management change was not significantly associated with cancer recurrence or overall survival (both P > .05).<h4>Conclusions</h4>In patients with resected head and neck cancer, postoperative, pre-adjuvant therapy FDG-PET/CT can alter clinical management and may enable additional personalization of treatment. When practical to obtain without delaying treatment, postoperative FDG-PET/CT may have clinical utility though requires careful interpretation due to the risks of false positives.JNCI cancer spectrumpkaf077https://www.ebi.ac.uk/biostudies/studies/S-EPMC12349773biostudies-literatureImpact of postoperative fluorodeoxyglucose positron emission tomography/computed tomography on adjuvant head and neck cancer treatment.PMC12349773Nabili VJafarvand MGBahri SSavjani RRSteinberg MLSt John MAKedeshian PASercarz JAChau LWChai-Ho WLee JKReddy VKChin RKLopez-Chicas REBlackwell KEChhetri DKCourtney PTKerr RPJuarez Casillas JEJank EAbemayor EWong DJLiu EYWang MBSim MSGopen QSSuh JDfalseImpact of postoperative fluorodeoxyglucose positron emission tomography/computed tomography on adjuvant head and neck cancer treatment.<h4>Background</h4>Residual or recurrent cancer after surgery but prior to adjuvant therapy occurs in a proportion of patients with head and neck cancer and may warrant treatment changes. 18-Fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) may help to identify residual or recurrent disease but is not routinely obtained. We evaluated the relevance of postoperative FDG-PET/CT in this clinical context.<h4>Methods</h4>This single-institution, retrospective study identified patients with head and neck cancer who underwent definitive surgery between January 1, 2013, and April 1, 2023, and received a postoperative FDG-PET/CT prior to adjuvant treatment. We measured the rates of management changes resulting from postoperative FDG-PET/CT findings and the association between having a postoperative FDG-PET/CT which resulted in a management change and oncologic outcomes with selected multivariable competing-risks and proportional hazards regressions.<h4>Results</h4>Of 150 patients, 66 (44.0%) had a management change because of the postoperative FDG-PET/CT findings; 62 (93.8%) had radiotherapy plan changes, 20 (30.3%) underwent additional diagnostic testing, 11 (16.7%) had systemic therapy added or changed, 3 (4.6%) underwent reresection, and 15 (10.0%) switched to palliative-intent treatment. Having a postoperative FDG-PET/CT that resulted in a management change was not significantly associated with cancer recurrence or overall survival (both P > .05).<h4>Conclusions</h4>In patients with resected head and neck cancer, postoperative, pre-adjuvant therapy FDG-PET/CT can alter clinical management and may enable additional personalization of treatment. When practical to obtain without delaying treatment, postoperative FDG-PET/CT may have clinical utility though requires careful interpretation due to the risks of false positives.2025-01-01T00:00:00Z2025 Jul2026-04-07T14:38:50.108Z2026-04-07T14:12:34.79ZS-EPMC123497734070060510.1093/jncics/pkaf077