Cavity Squamous Cell Carcinoma Research Articles

In Vivo Microstructure Imaging in Oropharyngeal Squamous Cell Carcinoma Using the Random Walk With Barriers Model.

Apparent diffusion coefficient is not specifically sensitive to tumor microstructure and therapy-induced cellular changes. To investigate time-dependent diffusion imaging with the short-time-limit random walk with barriers model (STL-RWBM) for quantifying microstructure parameters and early cancer cellular response to therapy. Prospective. Twenty-seven patients (median age of 58 years and 7.4% of females) with p16+/p16- oropharyngeal/oral cavity squamous cell carcinomas (OPSCC/OCSCC) underwent MRI scans before therapy, of which 16 patients had second scans at 2 weeks of the 7-weeks chemoradiation therapy (CRT). 3-T, diffusion sequence with oscillating gradient spine echo (OGSE) and pulse gradient spin echo (PGSE). Diffusion weighted images were acquired using OGSE and PGSE. Effective diffusion times were derived for the STL-RWBM to estimate free diffusion coefficient D0 , volume-to-surface area ratio of cellular membranes V/S, and cell membrane permeability κ. Mean values of these parameters were calculated in tumor volumes. Tumor microstructure parameters were compared with clinical stages of p16+ I-II OPSCC, p16+ III OPSCC, and p16- IV OCSCC by Spearman's rank correlation and with digital pathological analysis of a resected tissue sample. Tumor microstructure parameter responses during CRT in the 16 patients were assessed by paired t-tests. A P-value of <0.05 was considered statistically significant. The derived effective diffusion times affected estimated values of V/S and κ by 40%. The tumor V/S values were significantly correlated with clinical stages (r = 0.47) as an increase from low to high clinical stages. The in vivo estimated cell size agreed with one from pathological analysis of a tissue sample. Early tumor cellular responses showed a significant increase in D0 (14%, P = 0.03) and non-significant increases in κ (56%, P = 0.6) and V/S (10%, P = 0.1). Effective diffusion time estimation might impact microstructure parameter estimation. The tumor V/S was correlated with OPSCC/OCSCC clinical stages. 1 TECHNICAL EFFICACY STAGE: 1.

Does the mandibular lingual release approach impact post-operative swallowing in patients with oral cavity and/or oropharyngeal squamous cell carcinomas: a scoping review

ABSTRACT Dysphagia is a common consequence following surgical resection of oral cavity and/or oropharyngeal squamous cell carcinoma. Clinical anecdotal evidence suggests significant, long-term swallow compromise may result from following use of the mandibular lingual release approach (MLRA), though there is limited research to guide clinical care. A scoping review of MLRA and swallowing outcomes were conducted (1950–2020). Study quality was rated using the levels of evidence rating tool. Eight studies met inclusion criteria. All were retrospective cohort designs, exploratory in nature and rated as poor quality. Four reported swallow-related outcomes via a patient-reported tool and clinician-rated scale. Poor data specificity prohibited calculations of incidence or mean severity. Three papers hypothesized a link between the division of the digastric musculature and impaired post-operative mastication/swallowing. Current evidence is low quality and limited, restricting understanding of dysphagia post-MLRA. Future studies into the nature, biomechanics and recovery of swallowing are needed to develop care pathways for this population.

Occurrence and Prognosis of Secondary Lung Cancer inPatients with Primary Nasal Cavity and Sinus Squamous Cell Carcinoma.

There is an increasing focus on the burden of long-term survivors of secondary malignant neoplasms (SMNs) after the appearance of the primary tumor. Our goal was to describe the occurrence and prognosis of secondary lung cancer (SLC) in patients suffering from primary nasal cavity and sinus squamous cell carcinoma (NSSCC). Patients with NSSCC who reported to the Surveillance, Epidemiology and End Results (SEER) program between 1973 and 2017 were selected for our analysis. The Kaplan-Meier analysis was employed to predict the overall prevalence of SMNs and survival rates after the development of SMN. Standardized incidence ratios (SIRs) of SMNs have also been assessed after the development of the primary NSSCC. A total of 5354 patients were diagnosed with NSSCC. The type and date of diagnosis of the first malignancy were included in the records. In total 419 patients were reported to have developed SMNs within a median duration of 36months from the time of the primary to the secondary tumor diagnosis. The reported cumulative incidence of SMNs was 14% after 10years from the primary tumor diagnosis and 32% after 20years. Among the solid SMNs, secondary lung cancer was the most common malignancy, with cumulative incidences of 12.4% after 20years. The SIR of SMNs after the primary NSSCC compared with that of the general population was 1.65 and the 5-year overall survival (OS) rate following SMNs was 30%. The SMN lung cancer exhibited a SIR of 3.21 and was associated with a short-term median survival of only 11months. NSSCC survivors are at a high risk of developing SMNs, relative to baseline individuals. Lung cancer is one of the most common SMNs, and it has a poor outcome.

Abstract B22: A novel measurement neck brace for detecting range-of-motion changes with electromyography correlates in head and neck cancer patients undergoing neck dissection: A prospective pilot study

Abstract Introduction: Postoperative neck and shoulder dysfunction is recognized as a morbidity of neck dissection (ND) in head and neck cancer patients. However, the precise biomechanics and duration of neck mobility limitation have not been fully described. In current practices of more selective NDs, studies employing precise measurement techniques are needed to quantify the risk of postoperative neck range of motion (ROM) impairment in this patient population. Study Design: A prospective pilot study of five patients undergoing selective ND for head and neck cancer was conducted. A novel measurement brace was used to collect kinematic and concurrent EMG data on active ROM during standardized tasks for prespecified neck muscle groups at baseline and following ND. Methods: Patients without prior surgery or radiation undergoing unilateral ND for head and neck cancer were included. Patients were evaluated preoperatively and four weeks postoperatively. A novel neck brace developed for the purposes of this study was utilized to measure flexion, extension, lateral bending, axial rotation, and rolling movements. Angle of motion was measured from the neutral position to the end of each movement type as well as during total ROM from one movement type to the other (i.e., from neutral position to flexion as well as from flexion to extension). Baseline and postoperative EMG onset/offset data were collected for bilateral SCM, splenius capitis, and trapezius muscles to correlate muscle activation with angle of motion. Results: Five patients undergoing unilateral modified ND for cutaneous, oral cavity, or oropharyngeal squamous cell carcinoma completed preoperative and postoperative assessments. The average age was 57 years (54-60; sd 2.6). The greatest change in total ROM following surgery was seen in lateral bending, with a mean angle change of 17.3 (6.9-30.6; sd 8.5). Differences in lateral bending from neutral position were also seen for both the dissected and nondissected sides. Although degree of flexion and extension ROM were not affected by surgery overall, changes in the pattern of muscle group activation were evident. Conclusions: Measurement brace recordings suggest that active ROM limitation is most pronounced with lateral neck bending both to the ipsilateral and contralateral side of ND compared to other neck movements. EMG correlate data show increased variability in activation of muscle groups with flexion and extension movements. These preliminary results suggest that this device may serve as a useful diagnostic tool for patients undergoing ND. Additional data are needed to determine statistical and clinical significance of changes measured using this device. Future results may help guide clinicians in counseling patients about expectations following surgery as well as lead us to potential therapeutic targets from changes in muscle activation. Citation Format: Biing-Chwen Chang, Haohan Zhang, Ade Obayemi, Sallie Long, Scott Troob, Sunil Agrawal. A novel measurement neck brace for detecting range-of-motion changes with electromyography correlates in head and neck cancer patients undergoing neck dissection: A prospective pilot study [abstract]. In: Proceedings of the AACR-AHNS Head and Neck Cancer Conference: Optimizing Survival and Quality of Life through Basic, Clinical, and Translational Research; 2019 Apr 29-30; Austin, TX. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(12_Suppl_2):Abstract nr B22.

Factors impacting use of adjuvant therapy in lip and oral cavity squamous cell carcinoma: A NCDB analysis.

e18556 Background: Two trials followed by a combined analysis of the trials in head and neck squamous cell carcinoma (SCC) established that the benefit of adjuvant chemotherapy concurrent with radiation (CRT) was only noted in patients with extracapsular extension of nodal disease (ECE) and positive resection margins (PM). Despite this recommendation, other high-risk pathological features including pT3 or pT4 disease, positive lymph nodes, perineural involvement, vascular tumor embolism and level IV or V lymph node involvement have been noted to increase the risk of recurrence and adjuvant chemotherapy has been utilized for these patients. We report an observational study to evaluate the factors impacting use of CRT in patients with oral cavity and lip SCC. Methods: We conducted a retrospective study of patients with oral cavity and lip SCC who underwent resection of primary tumor with or without neck dissection in the reporting hospital in the NCDB database. We compared demographic, clinical and pathological characteristics of patients who received adjuvant CRT versus radiation alone. Multivariate analysis was performed using logistic regression model. Results: Out of the 58,481 patients reported to have surgery in NCDB from 2004 to 2016, 11,413 patients received adjuvant therapy. In univariate analysis, patients who received CRT were most likely less than 65 years of age, males, patients with no insurance or private insurance, lower Charlson Deyo score, Stage IVA, pT4, grade 2 or higher, tumor size &gt; 4cm, positive lymph nodes, involvement of level IV and V nodes, lymphovascular invasion, ECE and PM. In multivariate analysis, factors which influenced receiving CRT were age between 40 and 65 years, males, Stage IVA (compared to Stage I to III), positive nodes, ECE and PM. A total of 984 patients received CRT without having ECE or PM. Conclusions: In addition to ECE and PM, positive lymph nodes was the major pathological factor in patients receiving CRT compared to RT alone.

Survival for oropharyngeal and oral cavity cancer patients based on time to recurrence and HPV status.

e18544 Background: It is unknown whether patients with recurrent oral cavity (OC) or oropharyngeal squamous cell carcinoma (OPSCC) have improved survival if the recurrence occurs beyond one year. We analyzed a cohort of recurrent OC/OPSCC patients to study survival outcomes stratified by time to recurrence and human papillomavirus (HPV) status. Methods: From a cohort of 3201 OC/OPSCC patients initially diagnosed between 1/1/2008 and 6/30/2019, 235 recurrent cases were identified. Time from the end of treatment until first recurrence was ascertained by chart review. HPV status was determined by HPV testing or based on anatomical site. Overall survival (OS) rates and median OS time after diagnosis of recurrence was evaluated across the time-to-recurrence and HPV groups using the Kaplan-Meier method. Differences in the survival curves tested for using the log-rank test. Results: 130 (56%) of the recurrent tumors recurred &lt;1 year after end of treatment, and 104 (44%) ≥1 year. Patients with HPV-related tumors that recurred beyond one year had the best survival, with two-year OS at 0.62 (95% CI: 0.42-0.76), while patients with non-HPV related tumors that recurred &lt;1 year had the worst survival, two-year OS of 0.38 (95% CI: 0.28-0.48). HPV-related tumors that recurred &lt;1 year had roughly similar survival (two-year OS of 0.45, 95% CI: 0.30-0.59) to non-HPV-related tumors that recurred &lt; 1 year (two-year OS of 0.51, 95% CI: 0.38-0.62). The log-rank test for difference in survival across time-to-recurrence and HPV groups was significant at p=0.03. Conclusions: In our cohort, patients with HPV-related head and neck cancer with recurrence ≥1 year had improved survival compared to all other recurrent head and neck cancer patients. In addition, our findings suggest that patients with HPV-related head and neck squamous cell carcinoma who recur prior to 12 months have long-term survival similar to patients with HPV-unrelated cancers. This has important implications for clinicians treating patients with recurrent head and neck cancer and may help guide the design of future clinical trials. [Table: see text]

In Patients with Lateralized Oral Cavity and Oropharynx Squamous Cell Carcinoma with N2b Disease, Is It Safe to Omit Radiotherapy to the contralateral clinical N0 Neck?

In Patients with Lateralized Oral Cavity and Oropharynx Squamous Cell Carcinoma with N2b Disease, Is It Safe to Omit Radiotherapy to the contralateral clinical N0 Neck?

Mutational status of PIK3ca oncogene in oral cancer—In the new age of PI3K inhibitors

In the new age of PI3K inhibitors, the mutational status of PI3Kca oncogene in the Cavity Squamous Cell Carcinoma (OC-SCC) needs further analysis. It is the sixth most common cancer in the world. The aim of this study was to evaluate PI3Kca oncogene mutations and to correlate them with the clinical-histological characteristics of individuals presenting these tumors. We recruited 74 individuals with OC-SCC diagnosis (period 2000–2014). Histological sections were used. DNA was purified; PIK3ca gene exons 9 and 20 were amplified and sequenced. In 49/74 cases (66 %), the complete sequence of both codons was analyzed by Sanger method. We found that 7/49 (14 %) individuals mutated. In exon 9 we found 1/49 (2 %), and in exon 20 M1043I 8/49 (16 %). We have found the coexistence of more than one mutation in a same individual (E542 K and M1043I). A positive association was observed between the mutational status of the codon 9 (E542 K) and the tongue location. In conclusion, the frequency of PI3Kca gene mutation in OC-SCC was 16 %, which is similar to that reported for other populations. We found a mutation not previously described (M1043I) in this pathology. Should its biological effect be confirmed, it must be added to the list of PIK3ca mutations. Total mutations in the PIK3ca were 32 %, with tongue being the site at the greatest risk (E542K-E545K-M1043I). These findings would facilitate the identification of patients with therapeutic targets in the near future.

P53 and p16 expression in oral cavity squamous cell and basaloid squamous cell carcinoma

The true aggressive behavior of oral cavity BSCC compared to SCC has been debated, and the study of disturbances in cell cycle proteins may help understand the biological behavior in both variants. The aim of this study was to investigate the p53 and p16 status in 32 SCC and 16 BSCC of oral cavity. Immunohistochemistry was used to assess these proteins’ status. The association between p53 and p16 with clinico-pathological features and prognostic value were evaluated. A high prevalence of p53 disruption was observed in both variants (84.4% of 32—SCC and 81.2% of 16—BSCC; p = 0.78). The BSCC showed a higher prevalence of high p16 expression (86.7% of 15) when compared to SCC (61.3% of 31); however, this difference did not reach statistical significance (p = 0.08). In the SCC variant, cases with high p16 expression showed a lower overall survival. Protein p53 showed association with tobacco use, but with no other clinico-pathological features. Our results suggest that p53 and p16 cell cycle disruptions are common findings in oral cavity SCC, as well as in BSCC. A higher prevalence of p16 overexpression in oral BSCC cases may be related to carcinogenesis process.

Abstract 3503: Transcriptome analysis reveals differentially expressed lncRNAs between oral squamous cell carcinoma and healthy oral mucosa

Abstract Objective: Oral cavity and oropharyngeal squamous cell carcinoma (OSCC) is a major cancer type in the head and neck region. To better understand the roles long non-coding RNA (lncRNA) play in OSCC carcinogenesis, we compared the genome-wide gene expressions of lncRNA in OSCC and in the oral mucosa from healthy individuals. Materials and methods: We compared the expression levels of 3,054 probe sets for lncRNAs between 167 OSCCs and 45 healthy controls using an Affymetrix HG U133 plus 2.0 array dataset. We validated the top differentially expressed lncRNAs in three independent datasets in the Gene Expression Omnibus (GEO) repository: GSE42743, GSE9844, and GSE6791. We further tested the differential expression of the three lncRNAs showing the highest fold change by quantitative RT-PCR in a subset of 20 OSCCs and 10 control samples. Results: We found 658 lncRNA transcripts (790 probe sets) to be significantly differentially expressed between OSCC and healthy oral mucosa using a criteria of FDR&amp;lt;0.01, with 36 of them (39 probe sets) showing more than a 2-fold change. Among the 36, 14 (15 probe sets) lncRNAs were validated in all three independent datasets using the criteria FDR&amp;lt;0.01: LOC441178, C5orf66-AS1, HCG22, FLG-AS1, CCL14/CCL15-CCL14, LOC100506990, TRIP10, PCBP1-AS1, LINC01315, LINC00478, COX10-AS1/LOC100506974, MLLT4-AS1, MIR31HG, and DUXAP10/LINC01296. The differential expressions of LOC441178, HCG22 and C5orf66-AS1 were verified by qRT-PCR. Conclusion: We identified a number of differentially expressed lncRNAs using transcriptomic data between OSCCs and healthy oral mucosa. Further investigations into their potential role in OSCC carcinogenesis or to serve as OSCC biomarkers and/or therapeutic targets are warranted. Citation Format: Lu Feng, John R. Houck, Pawadee Lohavanichbutr, Chu Chen. Transcriptome analysis reveals differentially expressed lncRNAs between oral squamous cell carcinoma and healthy oral mucosa [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3503. doi:10.1158/1538-7445.AM2017-3503

Effect of p16 positivity in oral cavity and oropharyngeal squamous cell carcinoma

Effect of p16 positivity in oral cavity and oropharyngeal squamous cell carcinoma

Abstract 1087: Circulating microRNAs as metastasis biomarkers in oral cavity and oropharyngeal squamous cell carcinomas

Abstract MicroRNAs are small non-coding RNA molecules with roles in gene expression regulation and implications in cancer initiation and progression. Cell-free microRNAs detected in body fluids, and in particular in plasma, are of clinical interest due to their possible use as biomarkers. Despite the fact that their reliable quantification depends on several technical parameters, there is great clinical interest in this approach due to its simplicity and low risk to the patient. Squamous cell carcinoma of the head and neck is one of the most common cancer types worldwide, with survival rates of about 50% in 5 years. Tobacco and alcohol consumption are the most important risk factors and, currently, the presence of cervical lymph node metastases remain the strongest prognostic factor for this cancer type. In this study we identified plasma microRNAs associated with squamous cell carcinomas of the oral cavity and oropharynx as well as with the presence of cervical lymph node metastases. We evaluated the expression of 179 microRNAs in plasma from 45 patients (28 presenting cervical lymph node metastases at diagnosis and 17 with no lymph node metastasis) and 15 healthy controls. Samples were matched according to age, sex, drinking and smoking habits. Among microRNAs mostly expressed in tumor samples, some had been already detected in oral squamous cell carcinoma tissues, such as miR-210, while others, such as miR-573, are still poorly studied. Comparisons between oral and oropharyngeal carcinomas yielded several differences, in accordance with molecular distinctions between these cancer types. MicroRNAs possibly involved in the metastatic process were identified when comparing plasma samples from individuals presenting lymph node metastasis at diagnosis and plasma from patients who were metastasis-free. Among these molecules, miR-192 and miR-574 were identified as more expressed in plasma from individuals with metastatic oropharyngeal cancer. We conclude that plasma microRNAs associated with specific clinical conditions or cancer sub-sites may help in the diagnosis and prognosis assessment of head and neck squamous cell carcinomas. Citation Format: Flavia Maziero Andreghetto, Mariana Barbosa de Souza, Raquel Ajub Moyses, Tatiana Natasha Toporcov, Fabio Daumas Nunes, Marcos Brasilino de Carvalho, Patricia Severino. Circulating microRNAs as metastasis biomarkers in oral cavity and oropharyngeal squamous cell carcinomas. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1087.

Benefits and complications of Percutaneous Endoscopic Gastostomy (PEG) tubes in Head and Neck Oncology Patients

Background: Approximately 40-50% of oral cavity and oropharyngeal squamous cell carcinomas affect the tongue. The nodal metastasis can be affected by tumour thickness, site, size, differentiation, perineural and perivascular invasion. There is increasing evidence between close correlation of tumour thickness and nodal metastasis. We carried out a retrospective study of a 12 year period. Patients and Methods: 81 patients with anterior tongue SCC were involved in this study with a median age of 57 years. The follow-up period fluctuated between 24 to 84 months. Tumours exceeding T2 stage and spreading to other parts of the oral cavity were excluded. Surgery treatment was the only method employed. Results: 65 patients underwent local excision with selective neck dissection. Occult metastasis was present in 29 patients. In four of these patients tumour thickness was less than 5 mm (6%), whilst 25 (38%) patients illustrated thickness of more than 5 mm. The remaining 16 patients underwent local excision only. Four patients developed neck metastasis after a period of 6-18 months. Tumour thickness in one patient was less than 5 mm (6%) and remaining three patients more than 5 mm (18%). Conclusion:The results of our study support the evidence of close association between tumour thickness and nodal disease. Although local excision alone may be sufficient for cases with the tumour thickness of less than 5 mm, selective neck dissection is indicated when thickness exceeds 5 mm. There should be a standardised system among pathologists to record the tumour thickness at the time of initial diagnosis.

An Analysis of the Potential Benefits of Metformin on Disease Recurrence in Oral and Oropharyngeal Squamous Cell Carcinoma

Objective: Diabetes mellitus type 2 has been associated with increased cancer risk and cancer related mortality. Metformin, one of the most widely used anti-diabetic medications, has been found to have important anticancer properties in addition to hypoglycemic effects. The effects of metformin on clinical outcomes in oral cavity (OC) and oropharyngeal (OP) squamous cell carcinoma (SCC) have not been thoroughly analyzed. The purpose of this study was to evaluate the effects of metformin use on cancer recurrence in diabetic patients with oral cavity and oropharyngeal squamous cell carcinoma. Design: Retrospective review. Setting: Academic tertiary medical center. Patients: Seventy-seven patients with diabetes mellitus type 2 and oral cavity or oropharyngeal squamous cell carcinoma were treated and followed at our tertiary academic institution and the Veterans Affairs Greater Los Angeles Healthcare System from 1998 to 2012. Main Outcome Measure: Cox proportional hazards models and Kaplan-Meier curves were constructed to determine if metformin has an effect on disease recurrence after primary cancer treatment. Results: Metformin does not appear to have a significant effect on disease recurrence in patients with OC/OP SCC and diabetes mellitus type 2 (p = 0.53). Even when including only patients with stage I or II disease, metformin still did not decrease recurrence (p = 0.60). Conclusion: Herein, our data suggest that metformin use does not significantly impact time until recurrence for diabetic patients with OC/OP SCC.

Progressive increasing in the risk of second and subsequent malignant tumors in patients with a head and neck cancer: A validation study with SEER data.

5595 Background: Patients with a head and neck squamous cell carcinoma (HNSCC) index tumor have a increased risk (2-4% per year) for appearance of a second malignant neoplasms (SMN) and higher risk for successive malignant tumors during the follow-up. The objective of our study was to validate this concept with data of patients included in the Surveillance Epidemiology and End Results (SEER) program (1973-2008). Methods: We performed a population-based cohort study of 149.328 patients with a primary oral cavity, oropharynx, hypopharynx and larynx squamous cell carcinoma index tumor, included in the SEER program, to analize the actuarial survival-free of second and successive tumors. A total of 11.948 (8%) patients had one or more malignant tumors before the diagnosis of HNSCC. Results: During the follow-up period, a total of 31.507 new SMN appeared. There was a progressive and significant increase in the risk of SMN. The annual hazard ratio for 2nd to 7th successive SMN was 2.3%, 2.7%, 3.9%, 5.4%, 8.9% and 19.1% annual risk respectively. Additionally 11 patients had 8th SMN. We observed a progressive increase in the risk of appearence of new malignant tumors located in and outside the aerodigestive tract. The increase in the risk of SMN was higher for tumors located in the aerodigestive tract than tumors located outside aerodigestive tract. It was a tendency towards the increase in the proportion of HNSCC with the appearance of new tumors, with a decrease in the proportion of the malignant tumors located in the lung and in locations outside the aerodigestive tract. There were significant differences inthe risk of SMN between second and third, third and fourth, fourth and fifth, and sist and seventh tumors (p&lt;0.0001). Conclusions: In patients with HNSCC there is a progressive increase in the risk of appearance of successive tumors. Previous tobacco and alcohol consumption, persistence in the exposure to carcinogens and individual susceptibility (genetic) could play a role in the increased risk of SMN. We have validated this concept with data from the SEER program.

Differential expression of EGFR, HER2, P16, and high-risk (hr) HPV status in oropharyngeal (Or) and oral cavity (OC) squamous cell carcinoma (SCC).

5521 Background: We aimed to better characterize the expression of epidermal growth factor receptors family in Or and OC SCC and correlate it to hr HPV status and anatomoclinical features. Methods: In formalin fixed paraffin embedded tumor tissues, chromogenic in situ hybridization (CISH) was performed to detect hr HPV and immunohistochemistry to evaluate EGFR (positive score: 4 to 6), HER2 (0=negative, 1=positive) and P16 (positive score:≥70% labeled cells) expression. Baseline data were collected and analyze will be used. Results: Among 128 pts, 69 were tobacco users and 58 male. Median age at diagnosis was 61 y [23-95]. EGFR, Her2, P16 expression and hrHPV positivity were seen in 84 (65%), 12 (9%), 47 (37%) and 47 (37%) respectively. P16 signal was linked with absence of tobacco (31% vs. 72%, Pearson chi2 test: p&lt;10-3), absence of alcohol (48% vs. 83%, p&lt;10-3), Or site (53% vs. 76%, p=0.005), T1 (34% vs. 19%, p=0.06), N0 (52% vs. 23%, p=0.003), absence of nodal capsular rupture (85% vs. 68%, p=0.02), WHO grade 3 (37% vs. 68%, p=0.001), hr HPV detection (17% vs. 70%, p&lt;10-3). Multivariate analysis confirmed the link between P16 expression and hr HPV CISH positivity (OR=0.05, CI 95% [0.01-0.21], p&lt;10-3) , absence of tobacco (OR=9.2, CI 95% [2.1-40.7], p=0.03) and N0 (OR=0.2, CI 95% [0.04- 0.75], p=0.02). EGFR signal was linked with tobacco (31% vs 78%,p=10-3), alcohol (57% vs 81%, p=0.02), OC localization (77% vs 58%, p=0.03), well differentiated SCC (73% WHO grade 1-2 vs 56% grade 3, p=0.04), absence of hr HPV detection (74% vs 52%, p=0.01) and absence of P16 labeling (78% vs 44%, p&lt;10-3). Multivariate analysis confirmed the link between EGFR positivity and tobacco (OR=0.32, CI 95% [0.1-0.9], p=0.03), alcohol (OR=9.5, CI 95% [1.2- 72.8], p=0.03) and OC localization (OR=0.3, CI 95% [0.1-1], p=0.05). HER2 signal was linked with alcohol (5% vs 18%, p=0.04), history of tobacco associated neoplasia (10% vs 0%, p=0.02), Or site (14% vs 2%, p=0.03) and who grade 3 (5% vs 14%, p=0.06). Her2 labeling was not associated with tobacco, sex, hr HPV detection, P16 positivity or EGFR one. Conclusions: Hr HPV associated SCC have a low expression of EGFR and are not associated with HER2 labeling.

Role of panendoscopy to identify synchronous second primary malignancies in patients with oral cavity and oropharyngeal squamous cell carcinoma

Role of panendoscopy to identify synchronous second primary malignancies in patients with oral cavity and oropharyngeal squamous cell carcinoma

Detection of Human Papillomavirus Using Hybrid Capture 2 in Oral Brushings From Patients With Oropharyngeal Squamous Cell Carcinoma: Table 1

Detection of high-risk (HR) human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (SCC) has important prognostic implications; patients exhibit improved survival compared with patients with HPV- SCC. Oral brushing and rinsing samples were obtained from patients with oropharyngeal, oral cavity, or hypopharyngeal SCC and tested for HR-HPV using Hybrid Capture 2 (HC2; QIAGEN, Valencia, CA). HR-HPV in situ hybridization (ISH) was performed on biopsy tissue samples from the same patients. Oral cytologic samples from 16 SCCs were tested by HC2. Biopsy tissue samples were available for ISH in 11 cases. Five oropharyngeal SCCs were HR-HPV+ by ISH and HC2 (oral brushing). Of the oropharyngeal SCCs, 2 were positive by HC2 (oral brushing) and negative or equivocal by ISH. We found that 2 oral cavity carcinomas and 2 hypopharyngeal carcinomas were negative by HC2. One hypopharyngeal cancer was positive by ISH. All oral rinsing samples were negative by HC2. HC2 may be an effective method of determining HR-HPV status in patients with oropharyngeal SCC.

Outcomes of Gastrostomy Feeding Tubes in Patients Undergoing Primary Chemoradiation for Oral Cavity, Oropharynx, Hypopahrynx and Larynx Squamous Cell Carcinoma (SCC) at Nottingham University NHS Trust: a Retrospective Analysis 2004–2008

Outcomes of Gastrostomy Feeding Tubes in Patients Undergoing Primary Chemoradiation for Oral Cavity, Oropharynx, Hypopahrynx and Larynx Squamous Cell Carcinoma (SCC) at Nottingham University NHS Trust: a Retrospective Analysis 2004–2008

Prognostic significance of metabolic adaptation for hypoxic environment in oral squamous cell carcinoma

6082 Background: During tumor growth, tumor adapts the hypoxic environment and increases glycolysis. This metabolic switch is related to the aggressive malignant behavior. We investigated the connection between the biomarkers related to the glycolytic metabolism (HIF-1α, PDK-1, LDH-5) and clinicopathologic characteristics in oral cavity and oropharynx squamous cell carcinoma (SCC). Methods: Eligibility criteria was the patients diagnosed oral SCC, received curative radical resection and had available tissue samples. Immunohistochemical stain of the HIF-1α, PDK-1, and LDH-5 was done. Statistical analysis was performed to compare biomarkers between patients and time point. Results: Overall 74 patients were enrolled and stage grouping of the patients was as follows: stage I, 25 (33.8%) patients; stage II 17 (23.0%); stage III 8 (10.8%); stage IV 24 (32.4%). 25 patients were relapsed and 5-year disease-free survival (DFS) rate was 61.4%. High expression of HIF-1α was related to the advanced T stage (p = 0.029), more invasive tumor (p = 0.003) and tumor recurrence (p = 0.037). High expression of PDK-1 was related to the advanced N stage (p = 0.026) and high expression of LDH-5 was related to the lymphatics invasion (p = 0.028), advanced N stage (p = 0.020) and more invasive tumor (p = 0.015). The high expression of HIF-1α, PDK-1, and LDH-5 showed a significant correlation to each other. 16 (21.6%) patients were highly expressed all three markers. High expression of all three markers correlated with more invasive tumor (p = 0.004) and tumor recurrence (p = 0.017). In survival analysis, high expression of HIF-1α and LDH-5 associated with shorter DFS in log rank test (p = 0.002 and p = 0.016, respectively). High expression of all three markers was also associated with shorter DFS (p = 0.002). In multivariate Cox regression analysis, high expression of all three markers was strong independent prognostic factor for DFS (p = 0.021). Conclusions: The oral SCC which glycolytic metabolism was changed showed a more invasive and aggressive phenotype. Taken together, biomarkers related tumor metabolism may be independent prognostic markers for the DFS in the patients with oral SCC. No significant financial relationships to disclose.