Poster 010: Multivariate Analysis of Influencing Factors on Stomatitis in Reduced-Intensity Stem Cell Transplantation

Scientific Poster Session versity hospitals, 64 general hospitals, and 1 other institution. Results: Among the 1809 cases, 6 patients had intraoral multiple cancerous tumors (5 patients with 2 cancerous tumors, 1 with 3), thus a total of 1816 tumors were evaluated. The patients consisted of 1071 (59.2%) males and 738 (40.8%) females (male:female ratio, 1.45: 1), who had a mean age of 65.2 years old (SD: 13.9). The tongue (40.2%) was the most common site affected, followed by the gingiva (32.7%), buccal mucosa (10.1%), and oral floor (9.0%). In histopathological examinations, squamous cell carcinoma (88.7%) was the most common type found, followed by adenoid cystic carcinoma (2.1%), and mucoepidermoid carcinoma (1.7%). In addition, non-epithelial tumors comprised 1.8%, of which malignant melanoma was the most common type. Cases classified as T2N0 were the most common (32.1%), followed by T1N0 (21.4%), T4N0 (8.0%), and T2N1 (7.6%). Distant metastasis occurred in 17 patients (1.0%). The sizes of the non-epithelial malignant tumors ranged from 1.0 to 7.0 cm, with a mean size of 3.7 cm. Conclusion: In Japan, tongue cancer is the most prevalent type of oral cancer. In the present series, histopathological examinations showed that squamous cell carcinoma was the most common, and stage 1 and 2 cases accounted for half of the patients. Nevertheless, nearly half of the patients had advanced carcinomas. These results indicate the importance of early recognition of oral malignancy. References Franceschi S., Bidoli E., et al.: Comparison of cancers of the oral cavity and pharynx worldwide: etiological clues. Oral Oncol 36: 106115 2000 Carvalho A.L., Singh B., et al.: Cancer of the oral cavity: a comparison between institutions in a developing and a developed nation. Head Neck 26: 31-38 2004 Ravi M., Mamta S., et al.: Age specific incidence rate and pathological spectrum of oral cancer in Allahabad. Indian J Med Sci 57: 400-404 2003

POSTER 009 Methylations of p15 and p16 in Oral Precancers of Betel Quid Chewers in Sri Lanka Chihiro Sugiura, DDS, PhD, N-13, W-7, Kita-ku, Sapporo, Hokkaido, 0608586, Japan (Chiba I; Nagayasu H; Kitagawa Y; Shibata T) Statement of the Problem: Epidemiologic evidence indicates that there is an unequivocal relationship between betel chewing and oral carcinogenesis. The habit is endemic throughout the Indian subcontinent, large parts of south Asia including Sri Lanka. Oral squamous cell carcinoma (SCC) is the most common neoplasm in Sri Lanka, accounting for approximately 30% of all canAAOMS • 2007

cers in males.Thus, it is important to predict oral cancer risks and prevent oral cancers in betel quid chewers. It is also important to know biomarkers to predict malignant transformation of precancers such as oral leukoplakia and oral submucous fibrosis (OSMF). Although hypermethylation of tumor suppressor genes p15 and p16 can be detected in oral SCC as one of epigenetic changes, the hypermethylations in precancers are not fully understood. The present study was performed to address the role of the methylations of p15 and p16 as well as p53 overexpression, as possible biomarkers for predicting malignant transformation of precancers. Materials and Methods: We used 44, 20, 11 and 10 cases diagnosed as oral leukoplakia with mild dysplasia (OLMD), oral leukoplakia with severe dysplasia (OLSD), OSMF and normal epithelium for the analysis of hypermethylation. Method of Data Analysis: For statistic analysis, we used Fisher’s test. Results: In epithelial dysplasia and OSMF, the frequency of hypermethylation of p15 and p16 was significantly higher than those in normal epithelium. In the cases with p53 overexpression, there were no significant differences in the frequency of hypermethylation between p15 and p16. The frequency of p16 hypermethylation was significantly lower than that of p15 in OLMD cases, in the cases without p53 overexpression. The hypermethylations of p15 and p16 in OLSD and OSMF were frequent, in the cases without p53 overexpression. Conclusion: Betel quid chewing may cause p15 and p16 hypermethylation, associated with epithelial dysplasia. The detection of these hypermethylation may be useful as one of diagnostic tools for malignant transformation and evaluation of chemoprevention. References Chiba I: Prevention of Betel Quid Chewers’ Oral Cancer in the Asian-Pacific Area. Asian Pac J Cancer Prev 2001;2(4):263-269 Chiba I, Muthumala M, Yamazaki Y, Uz Zaman A, Iizukad T, Amemiya A, Shibata T, Kashiwazaki H, Sugiura C, Fukua H: Characteristics of mutations in the p53 gene of oral squamous-cell carcinomas associated with betel quid chewing in Sri Lanka. Int J Cancer

POSTER 010 Multivariate Analysis of Influencing Factors on Stomatitis in ReducedIntensity Stem Cell Transplantation Yumiko Ohbayashi, DDS, PhD, Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa Prefecture, 761-0793, Japan (Okamoto M; Higuchi A; Iwasaki A; Ogawa T; Miyake M; Nagahata S) Statement of the Problem: Allogenic hematopoietic stem cell transplantations have been shown to be estab43.e5

Scientific Poster Session lished treatment for haematological malignancies. Currently it is associated with a successful adaptation to solid tumors. Around 2000, reduced-intensity stem cell transplantation (RIST) which has reduced regimen-related toxicity, has been shown to be a safe and useful alternate transplant method for patients, most particularly those who are elderly. However, regimen related toxicity (RRT) including infection is observed as well as conventional stem cell transplantations (CST). Some reports showed RRT involving grade 3⬃4 severe stomatitis occurred in 30⬃50%. We intervened to recipients who underwent allogeneous SCT in our hospital from 2004 to the present time; these receipients included those on whom we performed oral health care intervention, including professional oral hygiene care. We also evaluated influencing factors on stomatitis within 100 days after RIST by multivariate analysis. Materials and Methods: A retrospective analysis was performed based on 55 patients who had received RIST between 2000 and March 2006 at the Kagawa Medical University Hospital. Method of Data Analysis: The clinical factors related to stomatitis were analyzed by multivariate analysis. Results: The incidence of stomatitis was 30.9% in 55 patients according to the National Cancer Institute Common Terminology Criteria for Adverse Events v3.0 (NCI CTCAE v3.0). The severe stomatitis of grade 3 was represented in 10.9% in 55 patients. Intervention of oral health care was P ⫽ 0.007, oral cryotherapy was P ⫽ 0.062 and related/unrelated donor was P ⫽ 0.068 by univariate analysis. The multivariate analysis shows P were 0.073, 0.672 and 0.368. Conclusion: The intervention of oral health care may be a viable avenue to aid in the prevention of stomatitis in RIST. References Wardley, A.M., et al., Prospective evaluation of oral mucositis in patients receiving myeloablative conditioning regimens and haemopoietic progenitor rescue. Br J Haematol, 2000. 110(2): p. 292-9. Oral mucositis and the clinical and economic outcomes of hematopoietic stem-cell transplantation. J Clin Oncol, 2001. 19(8): p. 2201-5.

POSTER 011 Introduction of DCLS, Dental Crisis Life Support, Course for Oral and Maxillofacial Practice Tomoyo Imamura, DDS, PhD, 2630 Sugutani Toyama City, Toyama, 9300194, Japan (Okudera H; Kurita K; Wakasugi M; Tange D; Yamamoto Y) Statement of the Problem: We developed one day ALS training course for DDS in Japan. On the basis of development, we analyzed opinions from DDSs attended one day ALS training system named ICLS. ICLS means Imme43.e6

diate Cardiac Life Support and developed by Japanese Association of Acute Medicine (JAAM). Materials and Methods: As first step, we performed ICLS provider course and ICLS instructor course for DDS. Since October, 2006, we performed three provider courses and one instructor course and produced 92 providers and 33 instructors using ICLS system. Based on these experiences, we made task force consists of emergency physicians and DDS instructors for development of one day ALS training course for DDS, DCLS course. Method of Data Analysis: DCLS means Dental Crisis Life Support. We designed General Instructional Objective, GIO, of the DCLS course as follows: to learn an appropriate response to dental crisis and an appropriate team management. Specific Behavioral Objectives, SBOs, of the DCLS course include BLS, Oeration of AED, Airway Management, Disswallowing and Swelling, Anaphylaxy, and Collapse. Based on the concept of DCLS, we published text book including course manual. Results: We provide a newly developed DCLS course as education course of 52nd Annual Meeting of Japanese Society of Oral and Maxillofacial Surgery, 30 September, 2007, in Nagoya.Detail of education course and results is presented for discussion. Conclusion: DCLS course is newly developed simulation training system, and crisis education system for oral and maxillofacial surgeons. References Yamahata, Y; Koike, K: Introduction of ICLS course and a condition of the cardiopulmonary resuscitation education in Japan, past,presently and futures. 7th Annual International Meeting on Simulation in Healthcare, Jan. 15-17, Walt Disney World Resort, FL, Imamura, T; Noguchi, M; Okudera, H: Modification of ICLS course for management of crisis situation in dental practice.

POSTER 012 Clinical Findings According To Indications for Third Molars Removal Luis A. Passeri, DDS, MS, PhD, Division of Oral and Maxillofacial Surgery, Piracicaba Dental SchoolUnicamp, Av Limeira, 901, Piracicaba, 13414-903, SP Brazil (Brasileiro BF; Oliveira C; Ambrosano GMB) Statement of the Problem: Oral and maxillofacial surgeons have seen the troubling consequences of third molar retention in daily practice: periodontal destruction, root caries, acute and chronic infection, and the morbidity of late extraction in older patients. However, extraction of third molars without symptomatology remains controversial and represents an important quality of life issue for a large number of patients. From this point of view, the objective of this research was to assess the preoperative and postoperative clinical findings of patients submitted to third molars removal based on symptomatic or asymptomatic indications. AAOMS • 2007