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OP123
S52
Abstracts / Oral Oncology 49 (2013) S4–S79
OP122 Field changes in the clinically normal contralateral mucosa of patients with oral pre-malignant and malignant lesions Maureen Sullivan, Vijayvel Jayaprakash, Jennifer Frustino, Mihai Merzianu, Nestor Rigual, Elizabeth Hatton, Rachael Rossitto, Nicole Hinchey, Mary Reid
on cancer, yet the greatest achievement is attributed to Sidney Farber, the father of modern chemotherapy. Sidney Farber accidently discovered a powerful anti-cancer chemical in a vitamin analogue and provided our first glimpse of hope for a universal cancer cure. Finally, we raise the question: Is cancers end conceivable in the future? doi:10.1016/j.oraloncology.2013.03.131
Roswell Park Cancer Institute, Buffalo, NY, USA Purpose: Presence of field cancerization is a major challenge in the management of oral squamous cell carcinomas (OSCC). These multifocal changes are often clinically imperceptible and can occur randomly in areas distant from the primary lesion. The prevalence of field changes in clinically normal contralateral mucosa has not been widely studied. Methods: Patients with suspicious oral lesion(s) are evaluated and biopsied at the Oral Cancer Screening Clinic at Roswell Park Cancer Institute. Selected patients with a primary index lesion (IL) that was histopathologically confirmed as oral pre-malignant lesions (OPLs)/OSCC were included in this study. All patients provided a control biopsy from a clinically normal contralateral site. Results: Eighty-one patients with IL were identified, 62 with squamous dysplasia (SD), 8 with carcinoma in situ (CIS), and 11 OSCC. Of these, 30 patients (37%) had OPLs/OSCC diagnosed on their contralateral control biopsies (27 mild-SD, 1 moderate-SD, 1 CIS and 1 OSCC). The prevalence of contralateral lesions (CL) was higher in males (45%) when compared to females (27%), though not statistically significant (p = 0.09). Other patient factors including age, race, smoking status, alcohol intake, and OSCC history were not predictive of the presence of CLs. Similarly, lesion factors such as location [gingiva (31%) vs. tongue (42%) vs. floor of the mouth (50%), p = 0.61], IL size [<2 cm (40%) vs. P2 cm (35%), p = 0.65], IL clinical appearance [single lesion (37%) vs. multifocal/generalized (35%), p = 0.87], and IL grade [SD (38%) vs. CIS (26%) vs. OSCC (36%), p = 0.75] did not predict CLs. Patients with multiple visible OPL/OSCC lesions had greater prevalence of CLs (46%) when compared to single OPL/OSCC (32%), however not statistically significant (p = 0.20). Conclusion: Over one-third of the patients presenting with OPL/ OSCC exhibited unexpected field changes in the clinically normal contralateral sites. Awareness of this fact is important for the treatment planning and follow-up for oral cancer. doi:10.1016/j.oraloncology.2013.03.130
OP123 The history of cancer Sharon Akrish Rambam Medical Center, Department Pathology, Haifa, Israel Rambam Medical Center, Department of Oral and Maxillofacial Surgery, Haifa, Israel Technion School of Medicine, Haifa, Israel This is a discussion on the history of cancer. It is a chronicle of an ancient disease that is often described as the defining plague of our generation; a disease we have lived with and perished from for more than 5000 years. We recount centuries of discoveries, setbacks and victories and discuss the potential for future cancer treatments. We examine the way doctors, scientists, philosophers and lay people have observed and understood the human body for a millennium. Countless individuals played a role in the war
OP124 The role of direct fluorescence visualization for screening of oral cancer in dental patients and its impact on raising awareness Cansu Alpaslan, Gökhan Alpaslan, Bug˘ra Yılmaz, Neda Hasanog˘lu, Berçem Kalender Gazi University, Faculty of Dentistry, Ankara, Turkey Purpose: Oral cancer accounts 3% of all cancers worldwide with an increase in rates for both sexes and rising trends in young men. As survival rate increases when diagnosed at early stages, systematic visual inspection is recommended at the beginning of dental treatment in each patient. However, diagnosis in clinically normal appearing mucosa and determine the malignant transformation of clinically visible erythroplakia and leukoplakia is not possible. Public awareness of OC has been reported to be very low, causing delay in referral and treatment. This study is aimed to assess VELscope system as a diagnostic adjunct to visual screening in symptomatic and asymptomatic patients. Additional aim was to evaluate the awareness of patients on oral cancer and their confidence with an adjunctive visualization tool. Material and methods: Eighty patients who admitted to oral surgery department for routine oral surgical procedures were examined by unaided eye and also by a hand-held device (VELscope) which permits direct fluorescence visualization of oral mucosa. Incisional biopsies were obtained from the areas with loss of autofluorescence that may indicate a neoplastic change in 14 patients. Awareness and knowledge of patients on oral cancer, and their reliability on an adjunctive aid in the diagnosis of oral cancer were evaluated by a written questionnaire. Results: Oral incisional biopsies revealed moderately differentiated squamous cell carcinoma, malign melanoma, lichen planus, and melanin incontinence. Direct fluorescence visualization was effective in distinguishing between normal and abnormal tissue but was unable to distinguish between different types of abnormal tissue. Awareness of patients on oral cancer was found to be very low. Screening with VELscope has been found more reliable than screening with unaided eye. Conclusions: Direct fluorescence visualization as a diagnostic adjunct, is a simple, efficient and reliable method for screening oral cancer that also helps to raise awareness. doi:10.1016/j.oraloncology.2013.03.132
OP125 The features of cervical node metastasis in young adults with oral squamous cell carcinoma Chuan Zhen Li, Chuan Bin Guo Department of Oral and Maxillary Surgery, Peking University of School of Stomatology, Beijing, China
Abstracts / Oral Oncology 49 (2013) S4–S79
OP122 Field changes in the clinically normal contralateral mucosa of patients with oral pre-malignant and malignant lesions Maureen Sullivan, Vijayvel Jayaprakash, Jennifer Frustino, Mihai Merzianu, Nestor Rigual, Elizabeth Hatton, Rachael Rossitto, Nicole Hinchey, Mary Reid
on cancer, yet the greatest achievement is attributed to Sidney Farber, the father of modern chemotherapy. Sidney Farber accidently discovered a powerful anti-cancer chemical in a vitamin analogue and provided our first glimpse of hope for a universal cancer cure. Finally, we raise the question: Is cancers end conceivable in the future? doi:10.1016/j.oraloncology.2013.03.131
Roswell Park Cancer Institute, Buffalo, NY, USA Purpose: Presence of field cancerization is a major challenge in the management of oral squamous cell carcinomas (OSCC). These multifocal changes are often clinically imperceptible and can occur randomly in areas distant from the primary lesion. The prevalence of field changes in clinically normal contralateral mucosa has not been widely studied. Methods: Patients with suspicious oral lesion(s) are evaluated and biopsied at the Oral Cancer Screening Clinic at Roswell Park Cancer Institute. Selected patients with a primary index lesion (IL) that was histopathologically confirmed as oral pre-malignant lesions (OPLs)/OSCC were included in this study. All patients provided a control biopsy from a clinically normal contralateral site. Results: Eighty-one patients with IL were identified, 62 with squamous dysplasia (SD), 8 with carcinoma in situ (CIS), and 11 OSCC. Of these, 30 patients (37%) had OPLs/OSCC diagnosed on their contralateral control biopsies (27 mild-SD, 1 moderate-SD, 1 CIS and 1 OSCC). The prevalence of contralateral lesions (CL) was higher in males (45%) when compared to females (27%), though not statistically significant (p = 0.09). Other patient factors including age, race, smoking status, alcohol intake, and OSCC history were not predictive of the presence of CLs. Similarly, lesion factors such as location [gingiva (31%) vs. tongue (42%) vs. floor of the mouth (50%), p = 0.61], IL size [<2 cm (40%) vs. P2 cm (35%), p = 0.65], IL clinical appearance [single lesion (37%) vs. multifocal/generalized (35%), p = 0.87], and IL grade [SD (38%) vs. CIS (26%) vs. OSCC (36%), p = 0.75] did not predict CLs. Patients with multiple visible OPL/OSCC lesions had greater prevalence of CLs (46%) when compared to single OPL/OSCC (32%), however not statistically significant (p = 0.20). Conclusion: Over one-third of the patients presenting with OPL/ OSCC exhibited unexpected field changes in the clinically normal contralateral sites. Awareness of this fact is important for the treatment planning and follow-up for oral cancer. doi:10.1016/j.oraloncology.2013.03.130
OP123 The history of cancer Sharon Akrish Rambam Medical Center, Department Pathology, Haifa, Israel Rambam Medical Center, Department of Oral and Maxillofacial Surgery, Haifa, Israel Technion School of Medicine, Haifa, Israel This is a discussion on the history of cancer. It is a chronicle of an ancient disease that is often described as the defining plague of our generation; a disease we have lived with and perished from for more than 5000 years. We recount centuries of discoveries, setbacks and victories and discuss the potential for future cancer treatments. We examine the way doctors, scientists, philosophers and lay people have observed and understood the human body for a millennium. Countless individuals played a role in the war
OP124 The role of direct fluorescence visualization for screening of oral cancer in dental patients and its impact on raising awareness Cansu Alpaslan, Gökhan Alpaslan, Bug˘ra Yılmaz, Neda Hasanog˘lu, Berçem Kalender Gazi University, Faculty of Dentistry, Ankara, Turkey Purpose: Oral cancer accounts 3% of all cancers worldwide with an increase in rates for both sexes and rising trends in young men. As survival rate increases when diagnosed at early stages, systematic visual inspection is recommended at the beginning of dental treatment in each patient. However, diagnosis in clinically normal appearing mucosa and determine the malignant transformation of clinically visible erythroplakia and leukoplakia is not possible. Public awareness of OC has been reported to be very low, causing delay in referral and treatment. This study is aimed to assess VELscope system as a diagnostic adjunct to visual screening in symptomatic and asymptomatic patients. Additional aim was to evaluate the awareness of patients on oral cancer and their confidence with an adjunctive visualization tool. Material and methods: Eighty patients who admitted to oral surgery department for routine oral surgical procedures were examined by unaided eye and also by a hand-held device (VELscope) which permits direct fluorescence visualization of oral mucosa. Incisional biopsies were obtained from the areas with loss of autofluorescence that may indicate a neoplastic change in 14 patients. Awareness and knowledge of patients on oral cancer, and their reliability on an adjunctive aid in the diagnosis of oral cancer were evaluated by a written questionnaire. Results: Oral incisional biopsies revealed moderately differentiated squamous cell carcinoma, malign melanoma, lichen planus, and melanin incontinence. Direct fluorescence visualization was effective in distinguishing between normal and abnormal tissue but was unable to distinguish between different types of abnormal tissue. Awareness of patients on oral cancer was found to be very low. Screening with VELscope has been found more reliable than screening with unaided eye. Conclusions: Direct fluorescence visualization as a diagnostic adjunct, is a simple, efficient and reliable method for screening oral cancer that also helps to raise awareness. doi:10.1016/j.oraloncology.2013.03.132
OP125 The features of cervical node metastasis in young adults with oral squamous cell carcinoma Chuan Zhen Li, Chuan Bin Guo Department of Oral and Maxillary Surgery, Peking University of School of Stomatology, Beijing, China