- Email: [email protected]
O155. The presence of occult metastases in non-sentinel lymph node in oral squamous cell carcinoma
free survival, local recurrence, failure in the neck and distant metastases and factors affecting them will also be studied. We will look at the relation between shoulder morbidity (pain and range of motion) and the function of the spinal accessory nerve after neck dissection. The requirements for and influence of perioperative blood transfusion on outcome will also be studied. Any impact of preradiotherapy haemoglobin levels on efficacy and outcome following radiotherapy will be defined. Lymph node yield and histopathological features of both the nodes and primary tumour and their influence on outcome will also be studied. Results: Data is being actively collected. The findings will be subjected to analysis and presented at the conference doi:10.1016/j.oos.2009.06.238
O154. Identification and validation of diagnostic/prognostic markers for tongue cancer A. Suresh a, M. Vannan a, K. Dhanya a, E.M. Elango a, K. Thangaraj a,b, M.A. Kuriakose a,* a b
Amrita Institute of Medical Sciences, Kochi, India Centre for Cellular and Molecular Biology, Hyderabad, India
India accounts for 1/3 of the oral cancer burden (30% of all cancers) with the age-adjusted incidence rate of tongue cancers in India (3.7–10.9/100,000) being one of the highest in the world. Tongue cancer is one of the most debilitating diseases due to its aggressive nature and the high rate of loco-regional recurrence (10–30%). Efforts were hence directed towards comparing recurrent and nonrecurrent tongue cancer patients by micro array and to validate the biomarkers in saliva, currently the method for easy and early detection of molecular markers. The expressions of 12 patients undergoing surgical treatment for tongue cancer were profiled using the HG U133 Plus 2 Array (Affymetrix). Statistical analysis within the groups revealed 86 genes in non-recurrent tumors (p < 0.001) and 59 in recurrent tumors (p < 0.01). A multivariate analysis using ANOVA across the different groups showed a total of 44 genes that had a pvalue less than 0.01. The recurrent pattern was distinct due to the up-regulation of G-Protein receptors, ABC transporters, Matrix metallopeptidases and growth factors with a complete absence of immune response. Subsets of these markers (MMP1, IL8, IL1B, FN1, FAPA, SERPINH2, ABCG1, COL5A1 and IgLA) were validated in tongue cancer samples. The markers were then validated retrospectively in saliva samples collected from patients and normal controls by Quantitative Real time PCR. Sixty-eight saliva samples (Normal, PMLs and T1/T2) were assessed for the integrity and specificity of RNA by RTPCR and sequencing methods. The levels were then correlated with the clinical details of the patients and a distinct association could be observed between the expression of the markers (MMP1, ABCG1, IL8, COL5A1, FN1) and the disease status in the patients. A prospective study with a larger number of samples is currently in progress as an effort to establish these biomarkers in the clinical setup. doi:10.1016/j.oos.2009.06.239
O155. The presence of occult metastases in non-sentinel lymph node in oral squamous cell carcinoma A.C. Christensen *, A.B. Bilde, M.H.T. Therkildsen, B.C. Charabi, J.K. Kirkegaard, L.S. Specht Dept. of ORL – H&N Surgery, Copenhagen University Hospital, Denmark Dept. of Pathology, Copenhagen University Hospital, Denmark Dept. of Oncology, Copenhagen University Hospital, Denmark
107
Introduction: The presence of lymph node metastases is considered the most important single adverse prognostic factor in head and neck cancer. To determine the presence of metastases in oral squamous cell carcinoma (SCC) sentinel-node biopsy (SNB) has proven to be technically feasible with a high degree of sensitivity. Many validation studies, however, are flawed in their histopathological design in that the histopathologic examination of the sentinel lymph node (SLN) and non-sentinel lymph node (NSNL) are different. The purpose of this study was to examine the occurrence of isolated tumour cells and micrometastases in NSLN using the additional step-serial sectioning and immunohistochemistry as for SLN. Methods: Fifty-one consecutive patients with oral SCC T1–T2 and a clinically N0 neck underwent surgical treatment including SNB-assisted neck dissection. The location of the SLN was determined using dynamic and planar lymphoscintigraphy and SPECT CT. The harvested SNL and NSNL from the subsequent neck dissection underwent the same histopathologic examination using step-serial sectioning at 150-lm intervals. Two sections from each level were stained with hematoxylin–eosin (H&E) and cytokeratin antibody AE1/AE3, respectively. Discussion: We have previously shown that 18% patients with subclinical (occult) lymph node metastasis were upstaged as a result of the additional histopathological examination of the SLNs. Routine H&E staining of the NSLN in our previous study identified only one lymph node with a macrometastasis. Results of the additional histopathological examination of the NSNL from the 51 patients are currently being processed and will be presented at the congress. Conclusion: Our previous study showed SNB-assisted neck dissection to be technically feasible in identifying subclinical metastases. Whether the NSLN from the subsequent neck dissection contain metastatic disease is very important to identify as this may have implications on the further treatment of the patient. doi:10.1016/j.oos.2009.06.240
O156. Nodal metastasis in clinical stage I and II tongue and floor of the mouth squamous cell carcinomas D.R. Camisasca a,*, F.L. Dias c, P.A.S. Faria d, D.A. Pereira b, G. Alves b, S.Q.C. Lourenco a a
Pathology Post Graduation Program, Fluminense Federal University (UFF), Brazil b Applied Genetics Laboratory, National Cancer Institute (INCA-RJ), Brazil c Head and Neck Service (INCA-RJ), Brazil d Pathology Division (INCA-RJ), Brazil Introduction: Tongue and floor of the mouth squamous cell carcinomas (TFSCC) are known for their high incidence of cervical metastasis, hence neck dissection is indicated even in stage I and II tumors. This study aimed to evaluate risk factors for regional metastasis in TFSCC. Methods: Thirty-two subjects (20 males and 12 females, ±54.1 years old) from a total of 249 TFSCC diagnosed in National Institute of Cancer (INCA-RJ), Brazil from August 2007 to September 2008 were included in the study. They were all submitted to radical surgical treatment with free margins followed by neck dissection. Patients were divided in two groups: with and without nodal metastasis. Clinicopathological variables analysed were sex, age, alcohol and tobacco use, tumor location, disease evolution, thickness, perineural invasion, tumor pattern of invasion, and WHO grading. Statistical analysis was performed through chi-square tests. Results: Sample was mainly composed by smokers (50%) and drinkers (62%) who complained of tongue tumors (46.9%) which
Oral AbstractsPoster ListOrals ListPan. Disc. & Symp. Abs.Keynote Abs.Keynote Bios.ProgramIAOOWelcomeCommittee Listings
Oral abstracts / Oral Oncology Supplement 3 (2009) 56–122
O154. Identification and validation of diagnostic/prognostic markers for tongue cancer A. Suresh a, M. Vannan a, K. Dhanya a, E.M. Elango a, K. Thangaraj a,b, M.A. Kuriakose a,* a b
Amrita Institute of Medical Sciences, Kochi, India Centre for Cellular and Molecular Biology, Hyderabad, India
India accounts for 1/3 of the oral cancer burden (30% of all cancers) with the age-adjusted incidence rate of tongue cancers in India (3.7–10.9/100,000) being one of the highest in the world. Tongue cancer is one of the most debilitating diseases due to its aggressive nature and the high rate of loco-regional recurrence (10–30%). Efforts were hence directed towards comparing recurrent and nonrecurrent tongue cancer patients by micro array and to validate the biomarkers in saliva, currently the method for easy and early detection of molecular markers. The expressions of 12 patients undergoing surgical treatment for tongue cancer were profiled using the HG U133 Plus 2 Array (Affymetrix). Statistical analysis within the groups revealed 86 genes in non-recurrent tumors (p < 0.001) and 59 in recurrent tumors (p < 0.01). A multivariate analysis using ANOVA across the different groups showed a total of 44 genes that had a pvalue less than 0.01. The recurrent pattern was distinct due to the up-regulation of G-Protein receptors, ABC transporters, Matrix metallopeptidases and growth factors with a complete absence of immune response. Subsets of these markers (MMP1, IL8, IL1B, FN1, FAPA, SERPINH2, ABCG1, COL5A1 and IgLA) were validated in tongue cancer samples. The markers were then validated retrospectively in saliva samples collected from patients and normal controls by Quantitative Real time PCR. Sixty-eight saliva samples (Normal, PMLs and T1/T2) were assessed for the integrity and specificity of RNA by RTPCR and sequencing methods. The levels were then correlated with the clinical details of the patients and a distinct association could be observed between the expression of the markers (MMP1, ABCG1, IL8, COL5A1, FN1) and the disease status in the patients. A prospective study with a larger number of samples is currently in progress as an effort to establish these biomarkers in the clinical setup. doi:10.1016/j.oos.2009.06.239
O155. The presence of occult metastases in non-sentinel lymph node in oral squamous cell carcinoma A.C. Christensen *, A.B. Bilde, M.H.T. Therkildsen, B.C. Charabi, J.K. Kirkegaard, L.S. Specht Dept. of ORL – H&N Surgery, Copenhagen University Hospital, Denmark Dept. of Pathology, Copenhagen University Hospital, Denmark Dept. of Oncology, Copenhagen University Hospital, Denmark
107
Introduction: The presence of lymph node metastases is considered the most important single adverse prognostic factor in head and neck cancer. To determine the presence of metastases in oral squamous cell carcinoma (SCC) sentinel-node biopsy (SNB) has proven to be technically feasible with a high degree of sensitivity. Many validation studies, however, are flawed in their histopathological design in that the histopathologic examination of the sentinel lymph node (SLN) and non-sentinel lymph node (NSNL) are different. The purpose of this study was to examine the occurrence of isolated tumour cells and micrometastases in NSLN using the additional step-serial sectioning and immunohistochemistry as for SLN. Methods: Fifty-one consecutive patients with oral SCC T1–T2 and a clinically N0 neck underwent surgical treatment including SNB-assisted neck dissection. The location of the SLN was determined using dynamic and planar lymphoscintigraphy and SPECT CT. The harvested SNL and NSNL from the subsequent neck dissection underwent the same histopathologic examination using step-serial sectioning at 150-lm intervals. Two sections from each level were stained with hematoxylin–eosin (H&E) and cytokeratin antibody AE1/AE3, respectively. Discussion: We have previously shown that 18% patients with subclinical (occult) lymph node metastasis were upstaged as a result of the additional histopathological examination of the SLNs. Routine H&E staining of the NSLN in our previous study identified only one lymph node with a macrometastasis. Results of the additional histopathological examination of the NSNL from the 51 patients are currently being processed and will be presented at the congress. Conclusion: Our previous study showed SNB-assisted neck dissection to be technically feasible in identifying subclinical metastases. Whether the NSLN from the subsequent neck dissection contain metastatic disease is very important to identify as this may have implications on the further treatment of the patient. doi:10.1016/j.oos.2009.06.240
O156. Nodal metastasis in clinical stage I and II tongue and floor of the mouth squamous cell carcinomas D.R. Camisasca a,*, F.L. Dias c, P.A.S. Faria d, D.A. Pereira b, G. Alves b, S.Q.C. Lourenco a a
Pathology Post Graduation Program, Fluminense Federal University (UFF), Brazil b Applied Genetics Laboratory, National Cancer Institute (INCA-RJ), Brazil c Head and Neck Service (INCA-RJ), Brazil d Pathology Division (INCA-RJ), Brazil Introduction: Tongue and floor of the mouth squamous cell carcinomas (TFSCC) are known for their high incidence of cervical metastasis, hence neck dissection is indicated even in stage I and II tumors. This study aimed to evaluate risk factors for regional metastasis in TFSCC. Methods: Thirty-two subjects (20 males and 12 females, ±54.1 years old) from a total of 249 TFSCC diagnosed in National Institute of Cancer (INCA-RJ), Brazil from August 2007 to September 2008 were included in the study. They were all submitted to radical surgical treatment with free margins followed by neck dissection. Patients were divided in two groups: with and without nodal metastasis. Clinicopathological variables analysed were sex, age, alcohol and tobacco use, tumor location, disease evolution, thickness, perineural invasion, tumor pattern of invasion, and WHO grading. Statistical analysis was performed through chi-square tests. Results: Sample was mainly composed by smokers (50%) and drinkers (62%) who complained of tongue tumors (46.9%) which
Oral AbstractsPoster ListOrals ListPan. Disc. & Symp. Abs.Keynote Abs.Keynote Bios.ProgramIAOOWelcomeCommittee Listings
Oral abstracts / Oral Oncology Supplement 3 (2009) 56–122