6th ICHNO Abstract Book

page 64 6 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 16 – 18 March 2017 Barcelona, Spain __________________________________________________________________________________________ 6th ICHNO

classification and excessive fluid administration increase the risk of re-operation for bleeding in patients undergoing HNC surgery. Moreover, patients with re-operation due to bleeding have over 5-fold risk for mortality. PO-133 Occult lymphnode metastasis in early stage OPC treated with TORS without neck lymphnodes dissection D. Alterio 1 , G. Marvaso 1 , S.F. Zorzi 2 , L. Preda 3 , A. Ferrari 1 , A. Rappa 4 , G. Giugliano 2 , F. Maffini 4 , D. Sibio 5 , C. Francia 5 , M. Cossu Rocca 6 , B.A. Jereczek-Fossa 5 , M. Ansarin 2 1 Istituto europeo di Oncologia, Radiotherapy, Milan, Italy 2 Istituto europeo di Oncologia, Head and Neck surgery, Milan, Italy 3 Istituto europeo di Oncologia, Radiology, Milan, Italy 4 Istituto europeo di Oncologia, Pathology, Milan, Italy 5 University of Milan, Oncology and Hematology, Milan, Italy 6 Istituto europeo di Oncologia, Medical Oncology, Milan, Italy Purpose or Objective Standard treatments for early stage (I and II) squamous cell oropharyngeal cancer (OPC) are both curative radiotherapy and surgery. Since the incidence of occult lymph node metastasis for early stage OPC is about 30%, an elective neck treatment is generally performed. We retrospectively evaluated consecutive patients (pts) with early stage (cT1-cT2 cN0) OPC treated with Transoral Oropharyngeal Robotic Surgery (TORS) without elective treatment on the neck lymph nodes. Aim of this analysis was to evaluate both locoregional control and impact on clinical outcomes of the deferred treatment of the neck lymph nodes . Material and Methods All consecutive pts treated with TORS without elective treatment on the neck (neither neck dissection, nor radiotherapy) were evaluated. Lymph node recurrences were classified as localized in the neck and/or in the retropharyngeal space (“retropharyngeal nodes”-RPN). Tumor recurrences of the “parapharyngeal space (PPS)” were considered separately. Results Twenty pts (7 female and 13 male, median age 61 years) met inclusion criteria. Median follow up was 28 months (mean 40 months, range 7-97months). Six and 14 pts had HPV positive HPV negative tumors, respectively. Ten (50%) pts experienced a locoregional tumor appearance after a median time of 10 months (mean time 11 months, range 4-17 months). As expected, 35% of patients experienced clinical appearance of occult lymph node metastasis (only in the neck lymph nodes in 5 patients, RPN 1 patient, neck lymph nodes and RPN 1 patient) after a median time of 10 months (mean 11 months, range 7-15 months). Of note, all three pts with PPS recurrences did not show any evidence of mucosal lesion in the oropharynx suggesting a submucosal localization of the tumor recurrence and authors suggested that this aspect could be probably related to a residual microscopic disease in the “T-N” tract (soft tissues and lymphatic network lied between the tumor and the neck lymph node chains). RPN metastasis appeared in 15% of pts. For the locoregional recurrences a second treatment was performed (Table 1). At last follow up 17 (85%) pts were alive without disease, two pts were alive with disease (one patient with distant metastasis and one patient with e second primary tumor in the supraglottic larynx) and one patient died for non-cancer related causes. Estimated 2-years overall survival and locoregional free-survival were 92.9% and 39.4%, respectively. Conclusion TORS without elective treatment of neck lymph nodes doesn’t represent a standard of care in early stage OPC

but our results suggested that pts treated with salvage treatments maintained good oncologic results. This study could provide useful information on both the occult lymph node metastasis (site and time of their clinical appearance) and the impact on clinical outcome of the deferred lymph node treatment in early stage OPC. PO-134 Retrospective analysis of treatment outcomes of sinonasal malignancies. Our 22-year experience P. Tarchini 1 , P. Farneti 2 , A. Bellusci 2 , V. Sciarretta 2 , E. Donini 3 , G. Frezza 3 , A. Tosoni 4 , A. Brandes 4 , E. Pasquini 5 1 Niguarda Ca' Granda Hospital, Ear- Nose and Throat Unit, Milan, Italy 2 Bologna University Medical School, DIMES - Ear- Nose and Throat Unit of Sant'Orsola Malpighi Hospital, Bologna, Italy 3 Bellaria Hospital- Azienda USL-IRCCS Institute of Neurological Science, Department of Radiotherapy, Bologna, Italy 4 Bellaria Hospital- Azienda USL-IRCCS Institute of Neurological Science, Department of Medical Oncology, Bologna, Italy 5 Azienda USL Bologna, Ear- Nose and Throat Metropolitan Unit, Bologna, Italy Purpose or Objective 1.We report our experience with surgical management of sinonasal malignancies 2.To assess the role of oncologic surgery alone or combined with radiotherapy and/or chemotherapy in A total of 132 patients with the naso sinusal malignancies between 1994 and 2015 were analyzed retrospectively. There were 86 males and 46 females; the average age was 59.1 years. The median follow-up time was 57 months (range 1-216 months). According to the American Joint Committee on Cancer 7th staging, patients were: 2 (1,5%) St I, 27 (20,3%) St II, 42 (31,6%) St III, 27 (20,3%) St IVa, 24 (18,0%) St IVb, 10 ( 7,5%) St IVc. The most frequent histotypes encountered were: adenocarcinoma 44 (33,8%), adenoid cystic carcinoma 24 (18%), squamous cell carcinoma 19 (14%), mucosal melanoma 11 (8,3%), Esthesioneuroblastoma 8 (6%), neuroendocrine nasosinusal carcinoma 8 (6%). Before the treatment, magnetic resonance imaging (MRI) and computed tomography (CT) were performed. 90 (68,2%) patientes were treated with exclusive endoscopic approach (EEA) and 42 pts (31,8%) with combined approach. Postoperative treatment were performed in 57 patients (43,2%): 35 patients received postoperative radiotherapy alone, 18 pts radiotherapy concomitant with chemotherapy and 4 pts CT only. Results Analyzing the cases based on a surgical technique, EEA and combined approach, we have noted the lack of statistically significant difference of survival between the two approach (5 year disease-specific survival respectively: 72,4% ± 5,6% vs 68,8% ± 7,8%; p=0,67). Twelve (9,1%) complications were present in 132 patients postoperatively without statistical difference between the two different approaches (10% vs 7.1%). Conclusion The results seem to indicate that endoscopic surgery, when properly planned and in expert hands, may be a valid alternative to standard surgical approaches for the management of malignancies of the sinonasal tract; less aggressiveness do not means less radicality. Follow the oncologic roles the endoscopic oncologic surgery alone or combined with external approaches achieves the same results. Every choice of treatment should be discussed by a dedicated oncology group formed by neurosurgeons, sinonasal malignancies Material and Methods