7th ICHNO Abstract book

page 36 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ 7th ICHNO

patients with regional relapse and in 8 cases of local failure. Patients who have recurred, either locally or regionally, had a lower 5-year disease-specific survival (56% vs 96%, P < 0.0001). The presence of perineural invasion correlated with recurrence and with lower disease-specific survival (p = 0.006 and p < 0.001, respectively). Tumor DOI ≥ 5 mm was associated with poorer disease-specific survival (p = 0.006). Lymph node dissection status or extent had no significant impact on survival or recurrence. Conclusion A favorable outcome was found in our series of patients with early stage OTSCC treated with surgery alone. Perineural invasion and tumor depth of invasion ≥ 5 mm correlated with poorer prognosis. Local or regional recurrent disease had a significantly worst survival outcome, regardless of salvage treatment. PO-069 Efficacy of Neoadjuvant chemotherapy in locally advanced oral cancers- a randomized pilot study P. Shivanna 1 , R. Pramanik 2 , A. Sharma 2 , R. Sahoo 2 , S. Bhaskar 3 , S. Thulkar 4 , S.V.S. Deo 1 1 AIIMS, Surgical Oncology, New Delhi, India; 2 AIIMS, Medical Oncology, New Delhi, India; 3 AIIMS, Radiation Oncology, New Delhi, India; 4 AIIMS, Radiodiagnosis, New Delhi, India Purpose or Objective Oral cancer is the third most common cancer in India. Majority present in a locally advanced stage. Surgery remains the mainstay of therapy for resectable oral cancers. However, the ideal management of locally advanced “borderline resectable” patients still continues to be debated. Non-surgical treatment options often result in poor locoregional control. Attempts at surgical resection upfront remains challenging as it often requires extensive resections and complex reconstruction, resulting in significant functional morbidity. Hence, the role of neoadjuvant chemotherapy (NACT) in locally advanced oral cancers has been evaluated. We undertook this study to compare the response to NACT with Paclitaxel + carboplatin (TP) and Cisplatin + 5 Flourouracil (PF) regimens separately. Material and Methods This was a prospective, open label, parallel design, randomised pilot study done from October 2017 to October 2018 in the department of Surgical Oncology at Dr BRA IRCH, AIIMS, New Delhi, India. All locally advanced carcinomas of oral cavity, (stage III or IVA), were included in the study. Borderline resectablity was defined (tumours involving two or more subsites, N2 nodal disease, involving low infra temporal fossa, reaching upto zygoma or hyoid bone, peritumoral edema involving more than 50% of face). All patients were randomly assigned to receive two cycles of either PF or TP. Clinico radiological response assessment was done and patients who were surgically resectable underwent surgery. Response rates and surgical conversions rates were analysed. Results A total of 56 patients were randomized to receive NACT, of which 43 patients completed the planned treatment. On per protocol analysis, 19 patients received PF and 24 patients received TP. Median age was 50 years. The primary site of involvement was predominantly alveobuccal (28 patients; 65. 12%). Majority had stage IVA disease (38 patients; 88%). The objective response rate was 34.88% and disease control rate was 39.5% for the overall cohort. The surgical conversion rate was 44.18%.

doses with the TNM classification was done using the Kruskal-Wallis test on the SPSS 20 software. In case of exceeding the constraints, we have done a new optimization. Results The average D40% recorded after the first planning was 7.4 Gy [2.06 - 21.34]. It was greater than 7.3 Gy in 7 cases (35%), for these 7 cases the tumors were classified as T4 in 3 cases, T2 in 1 case, T1 in 2 cases and T0 in 1 case. There was no significant correlation between the hippocampus dose and the TNM classification. After new optimization, taking into account the hippocampus, the D40% persisted high in only 2 cases. These two patients had a high tumor located with sphenoid involvement (T4). Conclusion The dose constraints at the hippocampus were respected in 65% of cases without it’s including in the optimization. Replanning, in case of exceeding dose, allowed adjusting the doses received in 2/3 of the cases. The high tumor extension is the limit to the protection of this organ. PO-068 Locoregional Relapse Impact on Survival for Resected Early Stage Oral Tongue Carcinoma M. Labareda 1 , E. Netto 1 , J. Filipe 2 , R. Pocinho 1 , A. Mota 1 , S. Esteves 3 , I. Fonseca 2 1 Instituto Português de Oncologia de Lisboa- Francisco Gentil, Radiation Oncology, Lisbon, Portugal ; 2 Instituto Português de Oncologia de Lisboa- Francisco Gentil, Pathology, Lisbon, Portugal ; 3 Instituto Português de Oncologia de Lisboa- Francisco Gentil, Clinical Research Unit, Lisbon, Portugal Purpose or Objective Report our outcomes of early stage oral tongue squamous cell carcinoma (OTSCC) treated with surgery alone in a single center cohort of patients. Material and Methods We have conducted a retrospective study of 71 consecutive patients with OTSCC treated with surgery alone at our institution between 2006 and 2010, staged as pT1-2N0 (AJCC 7 th edition) at the time of treatment. As tumor depth of invasion (DOI) has been incorporated in AJCC 8 th edition staging for oral cavity squamous cell carcinoma, a pathological review for its determination was performed and we evaluated its impact on staging and outcomes of a single center cohort of patients. The Kaplan-Meier method was used for recurrence-free survival and disease-specific survival analysis; log-rank test was performed for subgroup comparison. Results Median age was 62 years and 61% were male. Tumor was pT1 in 80% and pT2 in 20%; neck ultrasound was used for cervical staging and all were considered node negative. Partial glossectomy was done in every case and cervical lymph node dissection was performed in 31 (44%) of the patients. Only three patients underwent bilateral node dissection. Perineural invasion was present in 4 cases (6%) and vascular invasion in 2 (3%) patients. In ten patients (14%), surgical margins were positive or ≤1 mm. After pathological review, DOI was analyzed and in 14 cases (20%) was ≥ 5 mm; in 3 cases (4%) DOI was > 10 mm, meaning that a small percentage was restaged as pT3 (AJCC 8 th edition).With a median follow-up of 6.3 years (range, 0.05-11.4 years), the 5-year disease-specific survival and recurrence-free survival rates were 86% and 64%, respectively.Eight cases of regional relapse and 11 cases of local failure were found; three patients had locoregional recurrence. Twelve died due to tumor progression. Salvage treatment was conducted in 6