- Email: [email protected]
P269 Head & neck metastases: a 14 year retrospective study
Poster abstracts, Sunday 20 May
213
size (per cm), local invasion (T4 vs. T1), distant metastasis, tumour differentiation and treatment. Adjuvant radiotherapy reduced the risk of death from disease at 5 years by 50% (HR 0.5; CI 0.228, 0.995; P = 0.0486). Conclusion: Despite the diverse variety of malignant parotid tumors there are easily identifiable prognostic indicators, such as advanced age, tumor size, local invasion, and tumor differentiation that have a significant impact on outcome. Patients with adverse prognostic factors benefit from adjunctive radiotherapy and the threshold for the use of adjunctive radiotherapy in managing parotid malignancy should be low. Keywords: parotid, radiation, surgery, prognosis
respectively. Disease-free survival was 64 and 42% at 3 and 10 years. Conclusion: ACC of tongue is still a rare neoplasm, early diagnosis is important from a functional point of view, because this are slow growth tumors, producing diffuse invasion. Surgery is essential in treatment, and in cases with positive surgical margins, radiotherapy is indicated. Metastatic disease has a difficult treatment caused by the absence of an effective drug therapy, reason why overall survival has not improved in the last years. Keywords: Adenoid cystic carcinoma, Tongue, Minor salivary gland, Surgery
P266 Sentinel node biopsy in cutaneous malignancies of the head and neck experience in 32 patients and comparison with mucosal cancer
K. Luna-Ortiz1 *, T. Carmona-Luna1 , V. Villavicencio-Valencia1 , A.M. Cano-Valdez1 , M. Granados-Garcia1 , A. Mosqueda-Taylor1 . 1 Instituto Nacional de Cancerologia, Mexico, 2 Universidad Autonoma Metropolitana Xochimilco, Mexico
P268 Osteogenic sarcoma of maxillar region in Mexicans
Background: The excision of sentinel lymph nodes is accepted as a prognostic marker in malignant melanoma (MM). In the region of the head and neck, however, there are local particularities (parotid gland, facial nerve, bilaterality) of the method which are not yet examined thoroughly. Patients and Methods: Lymphoscintigraphy and gamma probe guided sentinel node biopsy (SNB) was carried out on 32 patients suffering from MM (Breslow >1 mm), squamous cell cancer (T1 2) and few other malignancies of the skin of the head and neck. All patients were pre-treated by diagnostic complete excision. Results: Lymphoscintigraphy detected sentinel nodes in 97%, all of which could be excised; 2 patients (6%) had positive nodes and were treated with a therapeutic neck dissection (ND). All patients live after a median observation time of 35 months. A large number of differences could be found in comparison to SNB in mucosal cancer of the oral cavity. Conclusion: The prognostic relevance of SNB in cutaneous malignancies of the head and neck is not yet established, and elective neck dissection still has to regarded as a viable alternative. Keywords: malignant melanoma, head and neck neoplasms, sentinel node, neck dissection P267 Adenoid cystic carcinoma of tongue V. Villavicencio-Valencia1 *, T. Carmona-Luna1 , A.M.. CanoValdez1 , A. Mosqueda-Taylor2 , K. Luna-Ortiz1 . 1 Instituto Nacional de Cancerologia, Mexico, 2 Universidad Autonoma Metropolitana Xochimilco, Mexico Objective: To observe demography of tongue Adenoid cystic carcinoma (ACC) at our institution, as well as c-kit expression, histologic pattern, prognostic factors, evaluate evolution, recurrence and/or persistence and overall survival. Methods: Retrolective study from 1986 to 2006, where we review a database of 68 patients with pathologic diagnosis of ACC of head and neck region. Results: We found 8 cases of tongue ACC, representing an 11.7% of all ACC of head and neck. Seven women (87%) and one man (12%) with mean age of 51 (range 33 67 years). Seven patients were treated with surgery, 3 cases required adyuvant treatment. Only one patient does not accept treatment. Mean time follow-up time was 5.3 years. 37% of patients presented metastasis during follow-up. The predominant histologic pattern was cribiform (6/8 cases). Perineural invasion was present in all cases, vascular invasion in one case. Inmunohistochemical with c-kit was positive for all cases. Overall survival was 51 and 34% at 5 and 10 years
Objective: To present demography of osteosarcoma of the maxillary region, histologic subtype, prognostic factors, followup, recurrence and/or persistence and free-disease survival and overall survival. Methods: Retrolective study from 1986 to 2006 where we select from a data base of all the cases of osteosarcoma of the head and neck, the cases localized at antromaxillary region, at the Instituto Nacional de Cancerologia, Mexico. Results: We present 21 cases, 11 (52%) women and 10 (48%) men, with an mean age of 37.5 years (range 16 76). Mean time of evolution before diagnosis was 13 months (range 0 to 120). The main symptom was a mass or swelling at maxillary region. Mean tumor size was 6x7 cm (range 2x10 to 4x15 cm). Inicial treatment was surgery in 19 cases, 17 of them with adyuvant treatment. The rest for irresecability were treated with radiotherapy and chemoradiotherapy. Six cases presented tumor persistence and 6 cases recurrence. The predominant histologic subtype was osteoblastic and fibroblastic, with a marked predominance of high grade (III). Mean time followup was 33 months. Overall survival was 47 and 23% at 5 and 10 years respectively, and a free-disease survival of 31% at 5 and 10 years. Conclusion: Antromaxillary osteosarcoma is a relatively infrequent tumor, with a rapid progression, reason why treatment must be given soon, based on surgery, with the aim of leaving negative surgical margins, and giving adyuvant radiotherapy and chemotherapy to prevent recurrences or extend free disease survival time. Overall survival time doubled compared with same histology at mandibular region. Keywords: Maxilla, Osteosarcoma, Head & Neck, Survival P269 Head & neck metastases: a 14 year retrospective study S. Irani1 *. 1 Faculty of Dentistry, Hamadan, Iran Metastases to head & neck area can occur either from local structures or from distant organs. The aim of this study was to review of clinical and histopathological features of metastases to head and neck area. For this purpose, a retrospective study was done, spanning the period 1991 2005, covering a total of 79 patients (48 male, 31 female; mean age: 46.8). All clinical and pathological data were considered. To ensure the accuracy of the pathological examinations, all the paraffin embedded blocks re-examined. The most common tumors were squamous cell carcinoma (19 cases) and papillary carcinoma (14 cases). Thyroid carcinoma accounts for approximately 26% of these metastases. The most common site for metastases was cervical lymph nodes. Keywords: Metastases, Head & Neck Area, Squamous Cell Carcinoma, Cervical Lymph Nodes
Poster abstracts
A.F. Kov´ acs, O. Seitz *, D. Zenkner, J. Diener, F. Gr¨ unwald, R. Sader. Goethe-University Medical School Frankfurt am Main, Germany
213
size (per cm), local invasion (T4 vs. T1), distant metastasis, tumour differentiation and treatment. Adjuvant radiotherapy reduced the risk of death from disease at 5 years by 50% (HR 0.5; CI 0.228, 0.995; P = 0.0486). Conclusion: Despite the diverse variety of malignant parotid tumors there are easily identifiable prognostic indicators, such as advanced age, tumor size, local invasion, and tumor differentiation that have a significant impact on outcome. Patients with adverse prognostic factors benefit from adjunctive radiotherapy and the threshold for the use of adjunctive radiotherapy in managing parotid malignancy should be low. Keywords: parotid, radiation, surgery, prognosis
respectively. Disease-free survival was 64 and 42% at 3 and 10 years. Conclusion: ACC of tongue is still a rare neoplasm, early diagnosis is important from a functional point of view, because this are slow growth tumors, producing diffuse invasion. Surgery is essential in treatment, and in cases with positive surgical margins, radiotherapy is indicated. Metastatic disease has a difficult treatment caused by the absence of an effective drug therapy, reason why overall survival has not improved in the last years. Keywords: Adenoid cystic carcinoma, Tongue, Minor salivary gland, Surgery
P266 Sentinel node biopsy in cutaneous malignancies of the head and neck experience in 32 patients and comparison with mucosal cancer
K. Luna-Ortiz1 *, T. Carmona-Luna1 , V. Villavicencio-Valencia1 , A.M. Cano-Valdez1 , M. Granados-Garcia1 , A. Mosqueda-Taylor1 . 1 Instituto Nacional de Cancerologia, Mexico, 2 Universidad Autonoma Metropolitana Xochimilco, Mexico
P268 Osteogenic sarcoma of maxillar region in Mexicans
Background: The excision of sentinel lymph nodes is accepted as a prognostic marker in malignant melanoma (MM). In the region of the head and neck, however, there are local particularities (parotid gland, facial nerve, bilaterality) of the method which are not yet examined thoroughly. Patients and Methods: Lymphoscintigraphy and gamma probe guided sentinel node biopsy (SNB) was carried out on 32 patients suffering from MM (Breslow >1 mm), squamous cell cancer (T1 2) and few other malignancies of the skin of the head and neck. All patients were pre-treated by diagnostic complete excision. Results: Lymphoscintigraphy detected sentinel nodes in 97%, all of which could be excised; 2 patients (6%) had positive nodes and were treated with a therapeutic neck dissection (ND). All patients live after a median observation time of 35 months. A large number of differences could be found in comparison to SNB in mucosal cancer of the oral cavity. Conclusion: The prognostic relevance of SNB in cutaneous malignancies of the head and neck is not yet established, and elective neck dissection still has to regarded as a viable alternative. Keywords: malignant melanoma, head and neck neoplasms, sentinel node, neck dissection P267 Adenoid cystic carcinoma of tongue V. Villavicencio-Valencia1 *, T. Carmona-Luna1 , A.M.. CanoValdez1 , A. Mosqueda-Taylor2 , K. Luna-Ortiz1 . 1 Instituto Nacional de Cancerologia, Mexico, 2 Universidad Autonoma Metropolitana Xochimilco, Mexico Objective: To observe demography of tongue Adenoid cystic carcinoma (ACC) at our institution, as well as c-kit expression, histologic pattern, prognostic factors, evaluate evolution, recurrence and/or persistence and overall survival. Methods: Retrolective study from 1986 to 2006, where we review a database of 68 patients with pathologic diagnosis of ACC of head and neck region. Results: We found 8 cases of tongue ACC, representing an 11.7% of all ACC of head and neck. Seven women (87%) and one man (12%) with mean age of 51 (range 33 67 years). Seven patients were treated with surgery, 3 cases required adyuvant treatment. Only one patient does not accept treatment. Mean time follow-up time was 5.3 years. 37% of patients presented metastasis during follow-up. The predominant histologic pattern was cribiform (6/8 cases). Perineural invasion was present in all cases, vascular invasion in one case. Inmunohistochemical with c-kit was positive for all cases. Overall survival was 51 and 34% at 5 and 10 years
Objective: To present demography of osteosarcoma of the maxillary region, histologic subtype, prognostic factors, followup, recurrence and/or persistence and free-disease survival and overall survival. Methods: Retrolective study from 1986 to 2006 where we select from a data base of all the cases of osteosarcoma of the head and neck, the cases localized at antromaxillary region, at the Instituto Nacional de Cancerologia, Mexico. Results: We present 21 cases, 11 (52%) women and 10 (48%) men, with an mean age of 37.5 years (range 16 76). Mean time of evolution before diagnosis was 13 months (range 0 to 120). The main symptom was a mass or swelling at maxillary region. Mean tumor size was 6x7 cm (range 2x10 to 4x15 cm). Inicial treatment was surgery in 19 cases, 17 of them with adyuvant treatment. The rest for irresecability were treated with radiotherapy and chemoradiotherapy. Six cases presented tumor persistence and 6 cases recurrence. The predominant histologic subtype was osteoblastic and fibroblastic, with a marked predominance of high grade (III). Mean time followup was 33 months. Overall survival was 47 and 23% at 5 and 10 years respectively, and a free-disease survival of 31% at 5 and 10 years. Conclusion: Antromaxillary osteosarcoma is a relatively infrequent tumor, with a rapid progression, reason why treatment must be given soon, based on surgery, with the aim of leaving negative surgical margins, and giving adyuvant radiotherapy and chemotherapy to prevent recurrences or extend free disease survival time. Overall survival time doubled compared with same histology at mandibular region. Keywords: Maxilla, Osteosarcoma, Head & Neck, Survival P269 Head & neck metastases: a 14 year retrospective study S. Irani1 *. 1 Faculty of Dentistry, Hamadan, Iran Metastases to head & neck area can occur either from local structures or from distant organs. The aim of this study was to review of clinical and histopathological features of metastases to head and neck area. For this purpose, a retrospective study was done, spanning the period 1991 2005, covering a total of 79 patients (48 male, 31 female; mean age: 46.8). All clinical and pathological data were considered. To ensure the accuracy of the pathological examinations, all the paraffin embedded blocks re-examined. The most common tumors were squamous cell carcinoma (19 cases) and papillary carcinoma (14 cases). Thyroid carcinoma accounts for approximately 26% of these metastases. The most common site for metastases was cervical lymph nodes. Keywords: Metastases, Head & Neck Area, Squamous Cell Carcinoma, Cervical Lymph Nodes
Poster abstracts
A.F. Kov´ acs, O. Seitz *, D. Zenkner, J. Diener, F. Gr¨ unwald, R. Sader. Goethe-University Medical School Frankfurt am Main, Germany