7th ICHNO Abstract book

7th ICHNO 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ page 49

surgery. Furthermore, the effect of intra-operative assessment on survival and recurrence rate was evaluated. Material and Methods Between 2010 and 2017 a total of 438 patients with oral squamous cell carcinoma were included. In 197 patients intra-operative assessment was used. In 87 patients tissue was sampled for frozen section procedure (defect driven), in 110 patients the resection specimen was intra- operatively evaluated by the pathologist (specimen The number of inadequate resection margins decreased from 85% to 41% when using specimen driven intra- operative assessment. Upon statistical analysis the adjusted logistic model showed that specimen driven approach significantly improved the number of adequate resection margins (Odds ratio 3.64, 95% CI 1.99- 6.63). There was no significant benefit of the defect driven approach in achieving adequate resection margins (Odds ratio 1.60, 95% CI 0.84-3.07). In the group of patients who received surgery between 2013-2017 the number of deaths was lower in the group with specimen driven approach (18%) compared to the other groups (27 and 28%), with an average follow up time of 26,4 months. Furthermore, the recurrence rate was lower in the group with specimen driven approach (15%) compared to the other groups (28 and 19%). Conclusion Intra-operative assessment of resection margins using the specimen driven approach can significantly lower the number of inadequate resection margins, resulting in improved survival and lower recurrence rate. Therefore, specimen driven approach should be standard care. PO-097 The role of T-N tract in advanced stage tongue cancer. M. Tagliabue 1 , S. Gandini 2 , V. Navach 2 , F. Maffini 2 , R. Bruschini 2 , G. Giugliano 2 , M. Tommasino 3 , L. Calabrese 2 , M. Ansarin 2 1 Istituto europeo di Oncologia, Division of Otolaryngology and Head and Neck Surgery, Milan, Italy; 2 European Institute of Oncology IRCCS, Division of Otolaryngology and Head and Neck Surgery, milan, Italy; 3 International Agency for Research on Cancer, Infections and Cancer Biology Group, Lyon, France Purpose or Objective The tongue is a very important organ involved in functional and relational life. The incidence of squamous cell carcinoma of the oral tongue (OTSCC) has increased in the last decades and its prognosis is still poor. We have analyzed a large series of patients with OTSCC, at homogeneous stage, treated in a single center with an identical surgical procedure: a compartmental tongue surgery (CTS) where the tumor is resected together with the limph node tract in an “ec bloc” resection. We investigated the prognostic factors responsible of local relapse and, in particular, the role of soft tissue tract between the primary tumor and the neck lymph nodes called T-N tract. Material and Methods We collected data on 322 patients with OTSSC, who underwent a CTS at the European Institute of Oncology, Italy. Chi-squared or Fisher's exact tests were used, crude cumulative incidence curves of local or distant reappearance, whichever occurred first, were computed in a competing risk framework. Overall Survival (OS) curves were estimated by the Kaplan-Meier method. The log-rank test was used to compare survival time between driven). Results

this is a great challenge. For oral cavity squamous cell carcinoma (OCSCC) only 15% of the resections are reported as adequate. To ensure an adequate tumor resection, evaluation of the entire resection surface is required. In the current clinical setting, this cannot be achieved, due to logistics and because it is a labor intensive procedure. In our institute we perform intra-operative assessment of resection margins which resulted in an improvement of adequate resection margins in OCSCC from 15% to 50%. However, this remains a subjective method which cannot be translated to all institutes. Therefore, an objective tool is needed for intra-operative assessment of resection margins. Our aim is to develop an objective method for fast and reliable intra-operative assessment of margins based on Raman spectroscopy. This is a non-destructive optical technique that provides (real-time) information about the molecular composition of tissues without the need for any tissue preparation. Our previous studies support the use of Raman spectroscopy for assessment of oral cavity squamous cell carcinoma (OCSCC) resection margins. We have shown in previous studies that Raman spectroscopy can discriminate OCSCC from the surrounding healthy tissue (both soft tissue and bone) and can be used to determine the OCSCC border in soft tissue, based on the water concentration calculated from the Raman spectra. Material and Methods We developed a Raman instrument employing a fiber optic-needle probe. Experiments were performed on fresh OCSCC resected specimen in which the fiber-optic needle is driven into the tissue. Along the insertion path of the needle, from the resection surface towards the tumor, successive Raman spectra are collected. From the Raman spectra the water concentration of the tissue located at a certain depth is calculated. This results in a water concentration profile which enables determination of the resection margins. Results This new instrument is currently being tested and the first results will be presented at the meeting Conclusion This development signifies an important step toward the validation and future implementation of a objective intraoperative tool for tumor resection guidance that will facilitate oncological radical surgery, reduce the need of adjuvant treatments, and improve patient's outcome. PO-096 Follow up after intra-operative assessment of resection margins in oral cavity carcinoma surgery R. Smits 1 , F. Van Lanschot 1 , T. Bakker Schut 2 , J. Hardillo 1 , H. Mast 3 , I. Ten Hove 3 , E. Wolvius 3 , G. Puppels 2 , R. Baatenburg de Jong 1 , S. Koljenovic 4 1 Erasmus MC, Otorhinolaryngology, Rotterdam, The Netherlands; 2 Erasmus MC, Center for Optical Diagnostics, Rotterdam, The Netherlands ; 3 Erasmus MC, Maxillofacial Surgery, Rotterdam,The Netherlands; 4 Erasmus MC, Pathology, Rotterdam, The Netherlands Purpose or Objective Inadequate resection margins form a important problem in oncological surgery. In recent years more and more evidence is available showing intra-operative assessment of resection margins can lower the number of inadequate resection margins. The goal of the present study was to determine the value of intra-operative assessment of resection margins in oral squamous cell carcinoma