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P2.31. Distant metastases in lip and oral cavity cancers
be diagnosed after the initial treatment and is associated with a poor survival. The aim in this study was to evaluate the incidence, risk factors for distant metastasis and long term survival. Methods: This study is based on a retrospective analysis of 106 patients with advanced stage oral carcinoma (all pN+) who underwent surgical treatment between January 1992 to December 2002. We studied the incidence of distant metastasis and survival after the diagnosis. In addition, we also evaluated several potential risk factors for distant metastasis as gender, age, T stage, N stage, local tumor, histologic grade, lymph node size, positive lymph nodes, positive lymph node levels, and others. Results: The incidence of distant metastasis was 19.8% (21/106), and the median overall survival after the diagnosis of distant metastasis was of approximately 3 months. Only one patient (5%) survived more than 12 months. The incidence of distant metastasis did not have any significant correlation with age, gender, T stage, N stage, clinical stage, tumor site, lymph node size, and histologic grade. However, the factors that were significantly associated with the occurrence distant metastasis were number of positive lymph nodes (P2 lymph nodes) (p = 0.026), presence of contralateral positive lymph nodeS (p = 0.002), more than two levels with positive lymph nodes (p = 0.008), and use of adjuvant radiotherapy (p = 0.042). Conclusion: This study confirm that the occurrence of distant metastasis in patient with advanced oral carcinoma is high (20%). The number of pathologic nodes, number of levels with positive lymph nodes and presence of bilateral neck lymph nodes were significantly associated with a higher risk of distant metastasis. Survival after the diagnosis of distant metastasis is usually lower than 1 year. doi:10.1016/j.oos.2009.06.432
P2.30. Postoperative complications after primary curative surgery for advanced oral and oropharyngeal carcinoma J. Gonçalves-Filho, E. Pontes, I.M.G. Agra, L.P. Kowalski* Hospital AC Camargo, Brazil Objective: This study analyze the incidence and risk factors of postoperative complications in patients submitted to primary curative surgery for advanced oral and oropharyngeal carcinoma. Methods: We reviewed the medical charts of 201 patients submitted to surgical treatment for advanced (all pN+) oral and oropharyngeal carcinoma, between January 1992 and December 2002. There were 178 male and 23 female, with a mean age of 57 years (ranging from 27 to 85 years). The tumor sites were oral cavity in 106 (53%) patients and oropharynx in 95(47%). Surgical procedure included 178 (88.6%) en bloc resections and 23 (11.4%) discontinous resections. Neck dissections were performed in all patients (ipsilateral in 111 and bilateral in 90). Results: The hospital stay varied from 3 to 41 days (median, 7 days). Postoperative complications occurred in 140 patients (69.7%). Forty-six patients (23%) had major complications, and 94 patients (46.7%) had minor ones. The most common complications were wound infection and dehiscence (37%, 75 patients). The postoperative mortality was of 2.5% (5 cases). The incidence of overall postoperative complications did not have any significant correlation with patient’s gender, age, tumor site, diameter of the lymph nodes, N stage and type of ipsilateral neck dissection. However, T stage (p = 0.024), clinical stage (p = 0.004), bilateral neck dissection (p = 0.01), and en bloc resection (p = 0.048) were significantly associated with the risk of postoperative complications. The occurrence of major complications was associated with the T stage (p = 0.01) and bilateral neck dissection (p = 0.012). Similarly, minor complications
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were associated with clinical stage (p = 0.002) and bilateral neck dissection (p = 0.004). Conclusion: Surgical treatment of advanced tumors of the oral cavity and pharyngeal is complex and can be performed with acceptable morbidity and low mortality. Clinical stage of the primary tumor, bilateral neck dissection, and en bloc resection were significantly associated with the risk of postoperative complications. doi:10.1016/j.oos.2009.06.433
P2.31. Distant metastases in lip and oral cavity cancers H.-A. Gitt* Practiceclinic Dr.Gitt, Leipzig, Germany Introduction: Distant metastases as a hard symptom of malignancy of tumor disease are found in 8–20% of oral cancer cases, but only 45% of these are confirmed by autopsy. Their prognostic influence is confirmed. The differentiation from second or third primaries is sometimes very complicated. The separation of the findings seems to be necessary because lip cancers,closely associated to skin tumors,are very different to the mucosal cancers of the oral cavity. Methods: The study reports on a retrospective explorative data analysis of 2481 oral cancer patients without any pre-treatment from 14 German hospitals. About 1229 were lip cancers and 1252 were oral cavity cancers. Gender: 78.4% male, 21.6% female. Average age 64.0 years (min. 13.8, max. 92.7). As statistical methods SPSS9, factor and cluster analysis were used. For the life-table method 2400 cases were controllable. Significance level alpha 5%. C-factor equal or greater 2 was 61.5%. Results: Distant metastases were found in 0.8% of lip cancers with great prognostical influence and in 3.4% of oral cavity cancers. Mainly localized in lungs and lymphatic system. A prognostical influence was confirmed. No gender specific results. Correlations to other findings are significant,like tumor localization (posterior third of tongue 8.7%, mandibular gingiva 7.1%),levels to the occlusal plane, infiltration, tumor size and regional metastases. No significant correlations exist in this study to pathohistological diagnosis, tumor mobility, tumor localization in regions (pre-, postcanin, postmolar), growth form (exo/endophytic) and bone destruction (X-ray). Discussion: The influence of distant metastases on prognosis of tumor disease is emphasized, also is underlined the necessity to examine for them. doi:10.1016/j.oos.2009.06.434
P2.32. Pattern of lymph node metastasis in a sample of patients with oral squamous cell carcinoma treated in the Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka A.M. Attygalla*, K. Koji, A. Horie University of Peradeniya, Sri Lanka Introduction: Oral Squamous cell carcinoma (OSCC) is one of the major preventable health problems in Sri Lanka. One of the important prognostic indicators in OSCC is the lymph node metastasis. The aim of this study was to determine the pattern
Poster Abstracts Oral AbstractsPoster ListOrals ListPan. Disc. & Symp. Abs.Keynote Abs.Keynote Bios.ProgramIAOOWelcomeCommittee Listings
Poster session II / Oral Oncology Supplement 3 (2009) 162–200
P2.30. Postoperative complications after primary curative surgery for advanced oral and oropharyngeal carcinoma J. Gonçalves-Filho, E. Pontes, I.M.G. Agra, L.P. Kowalski* Hospital AC Camargo, Brazil Objective: This study analyze the incidence and risk factors of postoperative complications in patients submitted to primary curative surgery for advanced oral and oropharyngeal carcinoma. Methods: We reviewed the medical charts of 201 patients submitted to surgical treatment for advanced (all pN+) oral and oropharyngeal carcinoma, between January 1992 and December 2002. There were 178 male and 23 female, with a mean age of 57 years (ranging from 27 to 85 years). The tumor sites were oral cavity in 106 (53%) patients and oropharynx in 95(47%). Surgical procedure included 178 (88.6%) en bloc resections and 23 (11.4%) discontinous resections. Neck dissections were performed in all patients (ipsilateral in 111 and bilateral in 90). Results: The hospital stay varied from 3 to 41 days (median, 7 days). Postoperative complications occurred in 140 patients (69.7%). Forty-six patients (23%) had major complications, and 94 patients (46.7%) had minor ones. The most common complications were wound infection and dehiscence (37%, 75 patients). The postoperative mortality was of 2.5% (5 cases). The incidence of overall postoperative complications did not have any significant correlation with patient’s gender, age, tumor site, diameter of the lymph nodes, N stage and type of ipsilateral neck dissection. However, T stage (p = 0.024), clinical stage (p = 0.004), bilateral neck dissection (p = 0.01), and en bloc resection (p = 0.048) were significantly associated with the risk of postoperative complications. The occurrence of major complications was associated with the T stage (p = 0.01) and bilateral neck dissection (p = 0.012). Similarly, minor complications
171
were associated with clinical stage (p = 0.002) and bilateral neck dissection (p = 0.004). Conclusion: Surgical treatment of advanced tumors of the oral cavity and pharyngeal is complex and can be performed with acceptable morbidity and low mortality. Clinical stage of the primary tumor, bilateral neck dissection, and en bloc resection were significantly associated with the risk of postoperative complications. doi:10.1016/j.oos.2009.06.433
P2.31. Distant metastases in lip and oral cavity cancers H.-A. Gitt* Practiceclinic Dr.Gitt, Leipzig, Germany Introduction: Distant metastases as a hard symptom of malignancy of tumor disease are found in 8–20% of oral cancer cases, but only 45% of these are confirmed by autopsy. Their prognostic influence is confirmed. The differentiation from second or third primaries is sometimes very complicated. The separation of the findings seems to be necessary because lip cancers,closely associated to skin tumors,are very different to the mucosal cancers of the oral cavity. Methods: The study reports on a retrospective explorative data analysis of 2481 oral cancer patients without any pre-treatment from 14 German hospitals. About 1229 were lip cancers and 1252 were oral cavity cancers. Gender: 78.4% male, 21.6% female. Average age 64.0 years (min. 13.8, max. 92.7). As statistical methods SPSS9, factor and cluster analysis were used. For the life-table method 2400 cases were controllable. Significance level alpha 5%. C-factor equal or greater 2 was 61.5%. Results: Distant metastases were found in 0.8% of lip cancers with great prognostical influence and in 3.4% of oral cavity cancers. Mainly localized in lungs and lymphatic system. A prognostical influence was confirmed. No gender specific results. Correlations to other findings are significant,like tumor localization (posterior third of tongue 8.7%, mandibular gingiva 7.1%),levels to the occlusal plane, infiltration, tumor size and regional metastases. No significant correlations exist in this study to pathohistological diagnosis, tumor mobility, tumor localization in regions (pre-, postcanin, postmolar), growth form (exo/endophytic) and bone destruction (X-ray). Discussion: The influence of distant metastases on prognosis of tumor disease is emphasized, also is underlined the necessity to examine for them. doi:10.1016/j.oos.2009.06.434
P2.32. Pattern of lymph node metastasis in a sample of patients with oral squamous cell carcinoma treated in the Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka A.M. Attygalla*, K. Koji, A. Horie University of Peradeniya, Sri Lanka Introduction: Oral Squamous cell carcinoma (OSCC) is one of the major preventable health problems in Sri Lanka. One of the important prognostic indicators in OSCC is the lymph node metastasis. The aim of this study was to determine the pattern
Poster Abstracts Oral AbstractsPoster ListOrals ListPan. Disc. & Symp. Abs.Keynote Abs.Keynote Bios.ProgramIAOOWelcomeCommittee Listings
Poster session II / Oral Oncology Supplement 3 (2009) 162–200