7th ICHNO Abstract book

page 94 7 th ICHNO Conference International Conference on innovative approaches in Head and Neck Oncology 14 – 16 March 2019 Barcelona, Spain __________________________________________________________________________________________ 7th ICHNO

SMM or MF alone were not significant predictors of OS. In multivariate analysis, sarcopenia remained a predictor of OS when corrected for age, BMI and comorbidity (HR 2.014, 95% CI 0.980-4.140, p=0.030). In subgroup analyses according to TNM-stage, treatment intention and sarcopenia, sarcopenia was only a statically significant prognostic factor in patients with TNM-stage I-III (HR 9.193; 95%CI 1.073-78.739; p=0.043) and in patients with curative treatment intention (HR 2.800; 95%CI 1.140- 6.877; p=0.025). Conclusion Skeletal muscle mass index and muscle function (as determined by muscle strength or physical performance measurements) were solely not prognostic in elderly head and neck cancer patients, but the combination of both was prognostic for overall survival. Therefore, sarcopenia should preferably (if muscle function data are available) be defined by the EWGSOP criteria and not by radiologically assessed skeletal muscle mass only. PO-179 A saliva-based assay to aid in the diagnosis of Oral Squamous Cell Carcinoma in a German Clinic M. Donovan 1 , C. Precht 2 , A. Forster 2 , E. Franzmann 3 , H. Hanken 2 , R. Smeets 2 1 Icahn School of Medicine at Mt. Sinai, Pathology, New York City, USA; 2 University Medical Center Hamburg- Eppendorf, Oral and Maxillofacial Surgery, Hamburg, Germany; 3 University of Miami, Otolaryngology, Miami, USA Purpose or Objective Head and neck squamous cell carcinoma (HNSCC), including oral squamous cell carcinoma (OSCC), is the 6th most common cause of cancer mortality. The ability to detect OSCC at an earlier stage could have significant impact on overall outcome. Previous studies demonstrated that a point-of-care (POC) lateral flow assay measuring CD44 and total protein (TP) aid in the diagnostic process for HNSCC. We sought to better understand the performance of the POC assay in a hospital-based oral and maxillofacial surgery clinic in Germany. Material and Methods Oral rinses were obtained from 90 patients at the Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Germany. Three cohorts of patients were prospectively enrolled: Group (Grp) A, patients newly diagnosed with OSCC; Grp B, healthy smokers (18-40 years, >100 cigarettes) and Grp C, normal healthy individuals (18-40 years, <100 cigarettes). Operators were provided POC visual tools to record assay results. A positive POC test is a visible CD44 band or level of TP (i.e. color-graded scale from 1-5, recommended >/=3), with Sensitivity (Se), Specificity (Sp), NPV to evaluate correlation with biopsy. Results 90 evaluable patients: Grp A: 100% OSCC, 50% Stage I/II, mean age: 68 years, 60% male, 59% smokers; Grp B: mean age 43 years, 59% male, 100% smokers; Grp C: mean age 43 years, 49% male, 94% non-smokers. Majority (>90%) subjects were white. Using POC levels of CD44 or a TP cut- off of >/=3, the assay achieved a Se of 76% in Group A. Comparing Grp A vs. Group B or C with a TP of 3 or greater produced a Sp of 88% and 85%, respectively. With a presumed population prevalence of 10%, the NPV was >90%. Poster: Immunodiagnosis and immunotherapy

and acute toxicities (≥ Grade 2 in CTCAE v5.0 scale) were compared between different treatment groups. Results Our study population had a median follow up of 8 months (6-32 months) ,median age of 73 years (70-93 years) with 52.5% patients of Stage IVA and 40% oropharyngeal malignancies.66.7% patients were able to take all intended ChT cycles. 22% patients in ChTRT,10% patients in ACRT and 16% patients in RT only arm has acute (≥ Grade 2 ) skin reaction. For mucositis, the incidences were 38.9%,30% and 8.3% respectively. For dysphagia, the incidences were 44.4%,40% and 50% respectively. For pain the incidences were 50%, 40% and 50% respectively. One patient (7.5%, in ChTRT arm) died due to severe dysphagia after completion of RT.7.5% patient had significant treatment delay (>7 days). Complete Response rate was better in ChTRT arm than others (94.4%, 80% and 75% respectively) Median PFS was better in ChTRT arm (5 months with a range of 3.4-6.6 months) than ACT and RT only arm (both arms had median PFS of 3 months). Conclusion All radical RT approaches are feasible and effective in Indian elderly SQCC-HNC patients. Definitive ChTRT is better in terms of CR rate & PFS but with more acute toxicities. Radical treatment strategy of elderly should be guided by clinical judgments not by chronological age. PO-178 Sarcopenia is a predictor for overall survival in elderly patients with head and neck cancer N. Chargi 1 , S. Bril 2 , M. Emmelot-Vonk 3 , R. Bree 1 1 UMC Utrecht, Head and Neck Surgical Oncology, Utrecht, The Netherlands; 2 UMC Utrecht, Medical Oncology, Utrecht, The Netherlands; 3 UMC Utrecht, Geriatrics, Utrecht, The Netherlands Purpose or Objective Low skeletal muscle mass (SMM) is associated with negative outcomes in cancer patients. According to the European Working Group on Sarcopenia in Older People (EWGSOP) criteria the definition of sarcopenia includes low SMM and low muscle function (MF; strength and/or performance). We investigated the relation between SMM, MF and overall survival (OS) in a group of elderly patients with head and neck squamous cell carcinoma (HNSCC). Material and Methods A retrospective study was performed in 85 elderly (³70- year old) patients who had a geriatric assessment before treatment of HNSCC between April 2015 and February 2018. Pre-treatment SMM was measured at the level of C3 and converted to SMM at the level of L3 using a previously published formula. A lumbar SMI <43.2cm²/m² was used to define low SMM. Handgrip strength and walking speed were measured using a hand dynamometer and the 4- meter gait speed test. Sarcopenia was classified according to the EWGSOP criteria. The prognostic value of SMM, MF and sarcopenia was investigated. Results Of the 85 included patients; 69 patients (81.2%) had low SMI, 50 patients (58.8%) had low HGS and 58 patients (68.2%) had low gait speed. According to the EWGSOP criteria, 41 patients (48.2%) were classified as sarcopenic. The median follow-up time was 11.14 months (IQR 3.64- 21.83 months); 33 patients (38.8%) died during the study period; 21 patients with sarcopenia and 12 patients without sarcopenia. The median overall survival was significantly worse for patients with sarcopenia (7.36 months; IQR 3.088-18.596) compared with patients with no sarcopenia (13.22 months; IQR 5.216-26.891) (HR 2.283; 95% CI 1.121-4.653; log rank test p=0.023).