ORIGINAL ARTICLE A combined analysis of maximum standardized uptake value on FDG-PET, genetic markers, and clinicopathological risk factors in the prognostic stratification of patients with resected oral cavity squamous cell carcinoma Chun-Ta Liao 1,2 & Chia-Hsun Hsieh 2,3 & Wen-Lang Fan 2,4 & Shu-Hang Ng 2,5 & Nai-Ming Cheng 2,6 & Li-Yu Lee 2,7 & Chuen Hsueh 2,7 & Chien-Yu Lin 2,8 & Kang-Hsing Fan 2,8 & Hung-Ming Wang 2,3 & Chih-Hung Lin 2,9 & Chung-Kan Tsao 2,9 & Chung-Jan Kang 1,2 & Tuan-Jen Fang 1,2 & Shiang-Fu Huang 1,2 & Kai-Ping Chang 1,2 & Li-Ang Lee 1,2 & Ku-Hao Fang 1,2 & Yu-Chien Wang 1,2 & Lan-Yan Yang 2,10 & Tzu-Chen Yen 2,6 Received: 8 May 2019 /Accepted: 18 July 2019 # Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Objective Clinical outcomes of patients with resected oral cavity squamous cell carcinoma (OCSCC) chiefly depend on the presence of specific clinicopathological risk factors (RFs). Here, we performed a combined analysis of FDG-PET, genetic markers, and clinicopathological RFs in an effort to improve prognostic stratification. Methods We retrospectively reviewed the clinical records of 2036 consecutive patients with first primary OCSCC who underwent surgery between 1996 and 2016. Of them, 345 underwent ultra-deep targeted sequencing (UDTS, between 1996 and 2011) and 168 whole exome sequencing (WES, between 2007 and 2016). Preoperative FDG-PET imaging was performed in 1135 patients from 2001 to 2016. Complete data on FDG-PET, genetic markers, and clinicopathological RFs were available for 327 patients. Results Using log-ranked tests based on 5-year disease-free survival (DFS), the optimal cutoff points for maximum standardized uptake values (SUV-max) of the primary tumor and neck metastatic nodes were 22.8 and 9.7, respectively. The 5-year DFS rates were as follows: SUVtumor-max ≥ 22.8 or SUVnodal-max ≥ 9.7 (n = 77) versus SUVtumor-max < 22.8 and SUVnodal-max < Chun-Ta Liao, Chia-Hsun Hsieh, Wen-Lang Fan and Lan Yan Yang con- tributed equally to this work. This article is part of the Topical Collection on Oncology – Head and Neck * Lan-Yan Yang lyyang0111@gmail.com * Tzu-Chen Yen yen1110@adm.cgmh.org.tw 1 Department of Otorhinolaryngology, Head and Neck Surgery, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, Republic of China 2 Department of Head and Neck Oncology Group, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, Republic of China 3 Department of Medical Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, Republic of China 4 Department of Genomic Medicine Core Laboratory, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, Republic of China 5 Department of Diagnostic Radiology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, Republic of China 6 Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital at Linkou, No. 5, Fu-Hsing ST., Kwei-Shan, Taoyuan, Taiwan, Republic of China 7 Department of Pathology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, Republic of China 8 Department of Radiation Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, Republic of China 9 Department of Plastic and Reconstructive Surgery, Linkou Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan, Republic of China 10 Department of Biostatistics and Informatics Unit, Clinical Trial Center, Chang Gung Memorial Hospital at Linkou, No. 5, Fu-Hsing ST., Kwei-Shan, Taoyuan, Taiwan, Republic of China European Journal of Nuclear Medicine and Molecular Imaging https://doi.org/10.1007/s00259-019-04453-x