Comorbidity scoring in head and neck cancer patients

284 and 4 N2c with 38 N0 disease negative necks. Two investigated ordinal type primary outcome measures were used: closest radial and closest deep margin. Over 30 pre-, intra- or postoperative factors impact was analysed. Conclusion: At least four factors for each outcome measures were identified which can predict close not sufficient excision margins. Using the coefficient and confidence intervals to be provided correction of techniques is possible. Independently the publication would also suggest some baselines for certain measures as to avoid incomplete excisions. Control over the identified statistically significant predictors can eliminate incomplete excisions potentially. Incomplete or narrow margin excision of tongue tumour is still rare possible. Control over the margins however mostly possible for good outcomes this is a must criteria. All possible steps should be followed to prevent incomplete excisions. http://dx.doi.org/10.1016/j.ijom.2017.02.955 Comorbidity scoring in head and neck cancer patients B. Edwards ∗ , K. Stewart, A. Al-Rikabi, C. Thomas Cardiff and Vale University Health Board, United Kingdom Background: Comorbidities in head and neck cancer patients can prohibit the use of preferred therapy and have a negative influence on the effectiveness of treatment, as well as impact on cancer survival statistics. The Adult Comorbidity Evaulation-27 (ACE27) is specifically designed for assessing comorbidities in patients with cancer. The National Cancer Intelligence Network (NCIN) recommends the collection of ACE-27 scores for all adult cancer patients. All patients discussed in the head and neck cancer multidisciplinary team (MDT) should have a correct ACE-27 score documented. Methods: The audit was a retrospective review of case notes and letters. 56 patients were identified from the DAHNO report as discussed in the MDT February to August 2015. Two investigators independently assessed the notes to complete scores. These were later compared with scores given during the MDT meeting. Data were recorded on an Excel spreadsheet and quantitative analysis performed. Results: 40 of the 56 (71%) patients had a co morbidity score recorded in the DAHNO report. 2 patients were excluded. 60.5% (n = 23/38) had scores which were correct on recalculation. Out of the total eligible patients, 42.6% (n = 23/54) had correct score recorded. Conclusion: Assessing comorbidities in newly-diagnosed cancer cases is important for informed patient treatment decisions, quality of life considerations, and to ensure high-quality cancer statistics. This audit has highlighted poor calculation and recording of comorbidity scores. We discuss some important steps we have undertaken to ensure correct score calculation. We encourage all head and neck cancer units in the United Kingdom to undertake this audit to ensure accurate scoring and management. http://dx.doi.org/10.1016/j.ijom.2017.02.956

Synchronous unilateral histologically different three parotid tumours S. Farook ∗ , A. Jay, S. Morley, N. Kalavrezos, Z. Sadiq Head and Neck Department, University College London Hospital, London, United Kingdom Background: Multiple tumours of unilateral parotid gland with different histology are rare. Although studies and case reports have presented this phenomenon no studies were found with more than two histologically confirmed tumours Methods: We present a case report of a 42-year-old gentleman who presented with an exophytic; rapidly growing left parotid lesion where the initial diagnosis of sarcomatous lesion was superseded by the final diagnosis of three histologically confirmed tumours. Results: Patient’s medical history, initial clinical, radiological and histological diagnosis and the final histological diagnosis are presented. The surgical management of this patient is also discussed. Conclusion: Synchronous multiple unilateral, histologically different parotid tumours usually include two. We present a patient with three histologically confirmed tumours within a unilateral parotid and how best to manage such cases. The importance of preoperative radiological and histological investigations together with a multidisciplinary approach in managing such patients is highlighted. http://dx.doi.org/10.1016/j.ijom.2017.02.957 Surgical management of deep lobe parotid tumours, presentation of three clinical cases and a review of the literature S. Farooq ∗ , D. Gahir, T. Malins University Hospital of North Midlands, Stoke-on-Trent, United Kingdom Background: Tumours of the parapharyngeal space occur infrequently, accounting for 0.5% of head and neck neoplasms. A majority of these are benign and approximately 50% of these arise from salivary glands as pleomorphic adenomas. These tumours although benign can prove to be a challenge to remove surgically due to the complex surrounding anatomy. The literature describes several approaches including the transcervical approach with or without lip split and mandibulotomy, transparotid combined with transcervical, transoral or transpalatal approaches Objectives: We describe our experience of using the transcervical transparotid approach in our case series of three deep lobe parotid tumours. Findings: The transparotid, transcervical approach is an effective means of accessing deep lobe tumours and successfully excising them. In our small case series of three patients, all were discharged without any significant complications and no facial nerve weakness. Conclusion: Our small case series of patients with deep lobe tumours demonstrates how effective the use of a transcervical; transparotid approach is in surgically removing parotid tumours of moderate size. The literature describes several approaches to excising deep lobe tumours invading the pterygoid space with various levels of success. The authors concur that in order to successfully remove these tumours, adequate exposure and protection