ICHNO-ECHNO 2022 - Abstract Book

S109

ICHNO-ECHNO 2022

Immunotherapy (IT) consisted of celimplimab delivered at 350 mg Q3W. In 2 cases pembrolizumab was given. In all cases IT was started before the radiation, was concurrent with radiation course and continued after RT course. Radiation was delivered to gross disease, yet 2 patients also received concurrent elective nodal radiation. Radiation doses were mostly (14/17) hypofractionation to lower total doses (10-45 Gy), yet three patients received curative RT intent (>60Gy). Duration of immunotherapy was short in 8 cases due to maximal response and side effect of fatigue (median IT duration was 4 months, range 1.5-12), while 6 patients currently continue immunotherapy. Local control was favorable with all evaluable patients (15) demonstrating disease control at last follow-up, though 1 patient required 2 nd course of RT. Radiation toxicities were dermatitis and mucositis all grade 2 or less, all resolved within 6 weeks. IT- toxicities were fatigue and weakness. 2 cases of neurologic symptoms (grade 2-3) that may have been related to IT. Although there was no added local toxicity at the radiation site with the combined used of RT-IT, we recorded three patients who died early (grade 5 toxicity). One may be attributed to IT, the others to comorbidities (pneumonia and hematologic malignanct), though treatment might have been a contributing factor. Conclusion Combined RT-IT may be a tolerable and effective alternative to standard full course of single modality therapy in elderly and frail patients with LA-SCSC without added local toxicity. Further studies are needed. H. Alsubaie 1 , K. Alsubaie 2 , F. Alzahrani 3 , M. Alessa 1 , S. Abdulmonem 4,5 , M. Merdad 6 , T. Al-Khatib 6 , H. Marzouki 7 , M. Algarni 8 , A. Alherabi 9,10 1 King Abdullah Medical City, Otorhinolaryngology, Head and Neck Surgery, Makkah, Saudi Arabia; 2 Alhada Armed Forces Hospital, Surgery, Taif, Saudi Arabia; 3 College of Medicine, King Saud University, Otorhinolaryngology, Head and Neck Surgery, Riyadh, Saudi Arabia; 4 King Abdullah Medical City, Otorhinolaryngology - Head and Neck Surgery, , Makkah, Saudi Arabia; 5 College of Medicine, Ain Shams University, Otorhinolaryngology, Head and Neck Surgery, Cairo, Egypt; 6 College of Medicine, King Abdulaziz University, Otorhinolaryngology - Head and Neck Surgery, Jeddah, Saudi Arabia; 7 College of Medicine, King Abdulaziz University,, Otorhinolaryngology - Head and Neck Surgery, Jeddah, Saudi Arabia; 8 College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, National Guard Hospital, Otorhinolaryngology - Head and Neck Surgery, Jeddah, Saudi Arabia; 9 King Faisal Specialist Hospital and Research Center - Jeddah, Otorhinolaryngology - Head and Neck Surgery, Jeddah, Saudi Arabia; 10 College of Medicine, Umm Al-Qura University, Otorhinolaryngology - Head and Neck Surgery, Makkah, Saudi Arabia Purpose or Objective We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) that scrutinized the oncological benefits and postsurgical complications of total thyroidectomy (TT) plus prophylactic central neck dissection (pCND) versus TT alone among clinically node-negative (cN0) papillary thyroid cancer (PTC) patients. Materials and Methods We screened five databases from inception until 04-September-2021 and evaluated the risk of bias of the eligible studies. We pooled dichotomous outcomes using the risk ratio (RR) with a 95% confidence interval (CI). Results Overall, we included five RCTs with low risk of bias comprising 795 patients (TT plus pCND=410 and TT alone=385). With regard to efficacy endpoint, the rate of structural locoregional recurrence did not significantly differ between both groups (n=5 RCTs, RR=0.49, 95% CI [0.19, 1.27], p=0.14). With regard to safety endpoints, the rates of hypoparathyroidism (n=4 RCTs, RR=1.48, 95% CI [0.73, 2.97], p=0.27), recurrent laryngeal nerve injury (n=5 RCTs, RR=1.34, 95% CI [0.59, 3.03], p=0.48), and bleeding (n=3 RCTs, RR=1.75, 95% CI [0.42, 7.26], p=0.44) did not significantly differ between both groups. Conclusion For cN0 PTC patients, there was no significant difference between TT plus pCND and TT alone with regard to the rate of structural loco-regional recurrence or frequency of postsurgical complications. Adaptation of pCND in cN0 PTC patients should be contemplated by taking into consideration the clinical oncological benefits and rate of postsurgical adverse events. PO-0172 Prophylactic central neck dissection for clinically node-negative papillary thyroid carcinoma

PO-0173 The impact of thyroid tumor features on lymph node metastasis in papillary thyroid carcinoma

F. Alzubaidi 1

1 King Abdullah Medical City , Otolaryngology Head and Neck Surgery Department , Makkah , Saudi Arabia

Purpose or Objective Our main objective is to evaluate the association between the size of the tumor and the number of lymph node metastases in patients with PTC. Materials and Methods We conducted an electronic retrospective chart review of 125 patients with PTC followed in the Head and Neck Department at KAMC from 2009 to 2020. Twenty-two patients included in our study were pathologically and clinically diagnosed and confirmed to have LNM of PTC.