HEAD & NECK JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK JULY 2015 VOLUME 37/NUMBER S1

CONTENTS E1

Welcome letter

E2

Committees

E7

Keynote lectures

E11

Oral presentations

E134

Poster presentations

IAOO Abstract Issue Dear colleagues, It is an honor for us to welcome you all to the 5th World Congress of the International Academy of Oral Oncology in 2015. On 2015 the International Academy of Oral Oncology is celebrating its 10th anniversary. IAOO has been drawing together clinicians and scientists worldwide, working on issues relating to the etiopathogenesis, epidemiology, prevention and management of oral and perioral tumors as well as oral diseases in patients with malignancies. The Academy has a commitment in oral oncology to improve health for present and future generations through an interdisciplinary perspective, objective, impartial interpretation of emerging evidence and timely application of knowledge and policies. The previous four IAOO World Congresses have been successfully held in 3 continents. The first was held in Amsterdam (2007), the second in Toronto (2009), the third in Singapore (2011) and the fourth in Rhodes (2013). The 5th IAOO World Congress is held in Brazil. The host place is the cosmopolitan Sao Paulo city, which has the largest infrastructure in Latin America and has the tradition of organizing huge international scientific meetings. São Paulo is the largest Brazilian city and has three international airports receiving direct flights from all over the world. It is considered an exciting location with hundreds of top class hotels and exciting fine dining, shopping, cultural life and touristic options. It can also be the port of departure for fascinating adventures in Amazon, Pantanal, incredible beaches and Iguaçu Falls. The IAOO Officers, Councilors, and the members of the Scientific and Local Organizing Committee of the 5th IAOO World Congress have all tried hard to develop an exciting scientific program covering all aspects with the latest evidence-based information on ORAL CANCER – A CONTINUING GLOBAL CHALLENGE. This meeting is designed for all those involved in multidisciplinary oral cancer research and management including the disciplines of head and neck surgery, otolaryngology, maxillofacial surgery, plastic surgery, medical oncology, radiation oncology, pathology, dentistry, epidemiology, basic and translational science, speech therapy, nutrition and nursery. Oral cancer remains one of the most challenging oncologic problems demanding a tremendous interaction among team workers and collaborators. With this in mind the program will create opportunities for numerous interdisciplinary interactions among health professionals from the youngest resident or fellow to the most senior scientists and oral oncology specialists. We welcome you all in Sao Paulo.

Alexander D. Rapidis

Luiz P. Kowalski

A. Moni Kuriakose

Patrick J. Gullane

Jatin P. Shah

President

Congress President

Secretary General

Treasurer

Chairman of the Council

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Committees Officers 2013 - 2015 President

Alexander D. Rapidis, Greece

Past President

Crispian Scully CBE, UK

President - Elect

Luiz P. Kowalski, Brazil

Secretary General

A. Moni Kuriakose, India

Treasurer

Patrick J. Gullane, Canada

Chairman of the Council Jatin P. Shah, USA Secretary General

Jay Boyle, USA

Councilors Chung Hwan Baek, Korea

J. Silvio Gutkind, USA

Peter Brennan, UK

Hans Langendijk, The Netherlands

Pankaj Chaturvedi, India

Jeannette Matsuo, Philippines

Terry Day, USA

Hisham Mehanna, UK

Andre Eckhardt, Germany

Ashok Shaha, USA

Dan Fliss, Israel

Richard Shaw, UK

Matthew Fury, USA

Giuseppe Spriano, Italy

Ralph Gilbert, Canada

David Wiesenfeld, Australia

Vincent Gregoire, Belgium Julia Woolgar, UK Chuan-bin Guo, China

Chenping Zhang, China

Honorable Local Advisory Committee Marcio Abrahao

Aline Lauda

Ivan M Agra

Carlos N Lehn

Albina Altemani

Jose Eduardo Levi

Claudio Rogerio Alves de Lima

Renan Bezerra Lira

Jose Leopoldo F. Antunes

David Livingstone A Figueiredo

Sergio S Arap

Marcio A Lopes

Leonardo Arcoverde

Ricardo Lopes Cruz

Fernando Arruda

Paula Angelica Lorenzon

Luiz Eduardo Barbalho

Jose Magrin

Mara Suzanna Behlau

Fernando Cotait Maluf

Antonio Bertelli

Rui Mamede

Eder R Biazolli

Jose Victor Maniglia

Lenine Garcia Brandao

Katia Maria Marabuco de Souza

Thiago Bueno de Oliveira

Vilma R Martins

Gilberto Castro Jr

Antonio Santos Martins E2

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Vera Cavalcante de Araujo

Luiz Roberto Medina dos Santos

Silvio Cavalcanti

Marcelo Benedito Menezes

Onivaldo Cervantes

Roberto E V Miguel

Roger Chammas

Ivan Miziara

Carlos Takahiro Chone

Jose Wilson Mourao de Farias

Thiago Celestino Chulan

Carolina Mozzini

Ricardo Coletta

Antonio Nascimento

Agricio Crespo

Jose Eluf Neto

Otavio Curioni

Fabio Daumas Nunes

Fabio de Abreu Alves

Orlando Parise Jr

Elizabeth Carrara de Angelis

Paola Pedruzzi

Roberto de Araujo Lima

Antonio Cassio Pelizzon

Andre Ywata de Carvalho

Geraldo Pereira Jotz

Genival Barbosa de Carvalho

Danyel E C Perez

Marcos Brasilino de Carvalho

Shirley Pignatari

Karina de Casssia Braga Ribeiro

Jorge Pinho

Jose Francisco de Gois Filho

Clovis A Pinto

Paulo A de Lima Pontes

Decio Santos Pinto Filho

Francisco Verissimo de Mello Filho

Fabio Ramoa Pires

Bartolomeu de Melo Jr

Jose Roberto Podesta

Denise Tostes de Oliveira

Jose Divaldo Prado

Jose Carlos de Oliveira

Gil Albrecht Ramos

Andre Bandiera de Oliveira Santos Gyl H. A. Ramos Jose Francisco de Sales Chagas

Abrao Rapoport

Sylvio de Vasconcelos

Ulysses Ribaldo Nicolau

Emmanuel Dias-Neto

Andre Caroli Rocha

Roberto Falzoni

Monica L Rodrigues

Marcelo Fanelli

Silvia R Rogatto

Jose Carlos M Faria

Joao Victor Salvajolli

Olavo Feher

Ricardo Santiago Gomez

Robson Ferrigno

Isabella Costa Santos

Victor Wunsch Filho

Carlos Roberto Santos

Joao Goncalves Filho

Roberto Santos da Silva

Eduardo Fregnani

Alan Roger Santos Silva

Antonio Geraldo do Nascimento

Laurindo M. Sassi

Dov Charles Goldenberg

Cristovam Scapulatempo

Antonio Jose Goncalves

Fernando A Soares

Edgar Graner

Ney Soares de Araujo

Jose Ricardo Gurgel Testa

Aldo C Stann

Rodrigo Hanriot

Marcio Studart da Fonseca E3

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Daniel Herchenhorn

Eloiza Helena Tajara

Paulo Hoff

Gilberto Vaz Teixeira

Mauro K Ikeda

Alfio Jose Tincani

Afonso Javaroni

Ronaldo Nunes Toledo

Jossi Ledo Kanda

Marco Aurelio Vamondes Kulcsar

Alberto Kato

Pablo Vargas

Arthur Katz

Jose G Vartanian

Jacob Kligerman

Andre Vetore

Hugo F Kohler

Mauro Becker Martins Vieira

Sergio Koifman

Luisa Lina Villa

Ricardo Kroef

Fernando Walder

Leonardo Kruchevski

Ulyanov

Cristina Kurachi

Honorable Advisory Committee Julio Acero, Spain

Dennis Kraus, USA

Marlinda Adham, Indonesia

Gregory Krempel, USA

Gregorio Aniceto, Spain

Yu Zhen Kun, China

Wadih Arap, USA

Kim Kwang, Korea

Athanasios Argiris, USA

Stephen Y. Lai, USA

Robert Baatenburg de Jong, The Netherlands Nancy Lee, USA Jose Bagan, Spain

C. René Leemans, The Netherlands

R. Bryan Bell, USA

Ilmo Leivo, Finland

Marco Benazzo, Italy

Lisa Licitra, Italy

Jean Bourhis, France

Thom Loree, USA

Javier Gavilan Bouzas, Spain

Jesus Medina, USA

Boudewijn J.M. Braakhuis, The Netherlands

Michelle Mignona, Italy

Carol Bradford, USA

Eric Moore, USA

Patrick J. Bradley, UK

Luc G. T. Morris, USA

James S. Brown, UK

Randall Morton, New Zealand

Daniel Buchbinder, USA

Jeffrey Myers, USA

Volker Budarch, Germany

Carlos Navarro Vila, Spain

Luca Calabrese, Italy

Pierro Nicolai, Italy

Joseph Califano, USA

Jose Luis Novelli, Argentina

Thomas Carey, USA

Chris Nutting, UK

Andre Lopes Carvalho, Brazil

Jan Olofsson, Norway

Claudio R. Cernea, Brazil

Kerry D. Olsen, USA

Mark Chambers, USA

Robert Ord, USA

Jimmy Chan, Hong Kong, China

Brian O'Sullivan, Canada E4

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Eun Chang Choi, Korea

Oslei Paes de Almeida, Brazil

Douglas Chepeha, USA

Vassiliki Papadimitrakopoulou, USA

Fausto Chiesa, Italy

Sat Parmar, UK

Ezra EW Cohen, USA

Maxine Partridge, UK

Peter Cordeiro, USA

Renata Pasqualini, USA

June Corry, Australia

Snehal Patel, USA

Maria Paula Curado, Brazil

Cesare Piazza, Italy

Sabrina Daniela da Silva, Brazil

Marco Piemonte, Italy

Anil K. D'cruz, India

Constantinus Politis, Belgium

Rogerio Aparecido Dedivitis, Brazil

Sandro Porcedu, Australia

Juan Postigo Dias, Brazil

Stephen Porter, UK

Luis Soto Dias, Brazil

Marshall Posner, USA

Eric Dierks, USA

Igor Reshetov, Russia

Andreas Dietz, Germany

Peter Rhys Evans, UK

Christian Domenge, France

John "Drew" Ridge, USA

David Eisele, USA

Simon R. Rogers, UK

Adel El-Naggar, USA

Jan L.N. Roodenburg, The Netherlands

Livia Escovich, Argentina

David Rosenthal, USA

Johannes J. Fagan, South Africa

Andrew Salama, USA

Ross D Farhadieh, Australia

Sandeep Samant, USA

Stefano Fedele, UK

Alvaro Sanabria, Colombia

Rui Fernandez, USA

Jorge Rosa Santos, Portugal

Robert Ferris, USA

Johh Sauk, USA

Marcelo Figari, Argentina

Brian Schmidt, USA

Robert Foote, USA

Jim Sciubba, USA

Arlene Forastiere, USA

Hao Sheng Po, Taiwan

Eduardo L Franco, Canada

Ashok Shenoy, India

Neal Futran, USA

Kamata Shinetsu, Japan

Ziv Gil, Israel

Ricard Simo, UK

Ann Gillenwater, USA

Bhuvanesh Singh, USA

Maura Gillison, USA

Robert Smee, Australia

Hans-Albrecht Gitt, Germany

Stephen Sonis, USA

Wojciech Golusinski, Poland

Khee Chee Soo, Singapore

Klaus W. Grätz, Switzerland

Paul Speight, UK

J. Silvio Gutkind, USA

Sandro J. Stoeckli, Switzerland

Ehab Hanna, USA

Carlos Suarez, Spain

Mia Hashibe, USA

Somasundaram Subramanian, Russia

Ryuichi Hayashi, Japan

Ted Teknos, USA

Richard Hayden, USA

Ogawa Tetsuya, Japan

Joseph Helman, USA

Michiel Van den Brekel, Netherlands E5

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Nilton Tabajara Herter, Brazil

Vincent Van Der Poorten, Belgium

Karl Hoermann, Germany

Isaac Van der Waal, The Netherlands

Colin Hopper, UK

Angel Vannelli, Argentina

Sefik Hosal, Turkey

Pablo Vargas ,Brasil

Subramania Iyer, India

Jan B. Vermorken, Belgium

François Janot, France

Francisco Vieira, USA

Jonas Johnson, USA

Kurt Vinzenz, Austria

Vinod K. Joshi, UK

Miso Virag ,Croatia

Deepak Kademani, USA

Saman Warnakulasuriya, UK

Nicholas Kalavrezos, UK

Randal S. Weber, USA

Avi Khafif Hefetz, Israel

William I. Wei, Hong Kong, China

Min Sik Kim, Korea

Gregory Weinstein, USA

Young Mo Kim , Korea

Jochen A. Werner, Germany

Jan Klozar, Czech Republic

William N William Jr, USA

Rainald Knecht, Germany

Ian Witterick ,Canada

Risto Kontio, Finland

Gregory Wolf, USA

Ronald Koole ,The Netherlands

John Yoo, Canada Bevan Yueh, USA

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KEYNOTE LECTURES

KEYNOTE  LECTURES  

EMERGING RADIATION TECHNOLOGIES TO PREVENT RADIATION INDUCED SIDE EFFECTS Johannes A. Langendijk Department of Radiation Oncology, University Medical Center Groningen, Groningen, The Netherlands Most new radiation technologies are introduced into routine clinical practice primarily to reduce radiationinduced acute and late side effects with similar tumor control. The introduction of IMRT has indeed led to a significant reduction of xerostomia and dysphagia. Radiotherapy with protons (proton therapy) is a rapidly evolving radiation technology that has important advantages compared to the currently used photons due to its unique energy absorption profile. Proton beams are typically manipulated to generate a spread-out Bragg peak to yield a flat dose profile across the target volume followed by a rapid decrease to nearly zero dose distally from the target, which results in highly conformal dose depositions in the target. Proton therapy will be particularly beneficial in head and neck cancer given that in this area the target volumes for radiotherapy are generally large and complex shaped and located near a variety of critical structures. Planning comparative studies indeed show that with proton therapy, the dose to the critical normal tissues can be reduced significantly and the first clinical studies confirm that proton therapy results in a significant decrease of radiation-induced side effects. Further improvement of this technique will come from image-guidance and plan adaptation, real-time dose verification technologies and emerging planning techniques to mitigate set up uncertainties and geographical changes during the course of radiation. THE SUCCESSES AND REALITIES OF NON SURGICAL TREATMENT OF HEAD AND NECK CANCER Jatin P. Shah, MD Memorial Sloan Kettering Cancer Center, New York, U.S.A Surgery has been the main stay of treatment of Head and Neck cancer for over one and a half century. Combining radiotherapy and chemotherapy with or without surgery, has evolved into several multidisciplinary treatment programs with the goal of preserving organ ( larynx), and reducing the functional and esthetic sequela of surgery. The larynx preservation concept has been extrapolated to other sites. This concept has been tested in several randomized trials. In addition concurrent administration of Chemo and Radiotherapy, has shown the best oncologic outcomes. Long term data however show, that the function of the preserved organ is not optimal in some patients, and in fact long term survivorship for larynx cancer has indeed declined in the united states in the past two decades. In addition, anywhere from 20-70% of patients fail chemo radiotherapy and need salvage surgery. Significant pre operative planning is required to carry out successful salvage surgery without complications. In spite of that these operations are complex, extended, morbid, and fraught with the danger of wound complications, and high risk of treatment failure. The surgeon’s ability to accurately define the extent of residual or recurrent tumor is seriously compromised, due to extensive post treatment fibrosis, and ill defined nature of the cancer, since recurrent tumor often presents with numerous foci of viable tumor cells in a “sea of post treatment fibrosis”. This often results in biologically positive margins, or local recurrence, in spite of securing histologically negative margins. The radiated tissues have poor healing ability leading to wound failure and fistulae. Thus regional or free flaps are required to bring in new blood supply from non radiated tissues. In spite of all these efforts the success rate of salvage surgery is poor. Some times extensive salvage surgery is required for palliation to improve the quality of life, even if cure is not possible. E7

IAOO Abstract Issue Persistent palpable or radiological abnormality in the neck is quite common when chemo radiotherapy is employed in patients with palpable neck metastases. Documenting viable tumor in such persistent abnormality in the neck is often difficult. While PET scan is reliable in detecting viable tumor, it is not always accurate. Another unanswered question is the extent of neck dissection in this setting. Finally, some patients with persistent or recurrent metastatic nodes will have significant extranodal disease in soft tissues requiring further treatment. Planning of the surgical procedure with the availability of IORT or brachytherapy, and reconstruction with a regional or free flap, to bring in vascularized tissue is crucial for a successful surgical outcome. Thus in this presentation, all the issues and complexities of safe salvage surgery for a successful oncologic outcome will be discussed. ADVANCING SURGICAL THERAPY AND TARGETED THERAPEUTICS IN HEAD AND NECK CANCER TOGETHER Joseph Califano Johns Hopkins Hospital, Baltimore, U.S.A.

  Advances in head and neck cancer management have included technologic advances in surgical technique that have changed the management of head and neck cancers throughout the upper aerodigestive tract. Concurrently targeted therapy has shown significant promise in providing alternative therapies for head and neck cancer, and do not fit within the categories of traditional surgical, radiation, and cytotoxic chemotherapy. This presentation will focus on opportunities provided by both advances in transoral surgical therapies as well as novel targeted therapies and the potential for these newer treatment modalities to be used together in treatment escalation and de-escalation strategies for the treatment of head and neck cancer. HPV ANTIBODIES AND THE SUBSEQUENT OCCURRENCE OF OROPHARYNX CANCER Paul Brennan International Agency for Research on Cancer, Lyon, France Human papillomavirus type 16 (HPV16) infection is causing an increasing number of oropharyngeal cancers. There is strong emerging evidence that antibodies to HPV type 16 are highly sensitive for HPVpositive oropharynx cancer and occur unto 15 years before clinical presentation. These observations through up a number of questions including (i) is a simple HPV antibody test a more accurate marker for HPV associated oropharynx cancer than other tumour tissue based tests?, (ii) what is the potential for HPV antibodies to identify individuals destined to develop HPV associated oral cancer before clinical symptoms occur, and (iii) is there any possible clinical utility with respect to determining outcome? THE INTERNATIONAL ACADEMY OF ORAL ONCOLOGY. THE PAST, THE PRESENT AND THE FUTURE OF A COMMON EFFORT TO FIGHT ORAL CANCER. Alexander D. Rapidis MD DDS PhD FACS IAOO President Department of Head and Neck Surgery, Greek Anticancer Institute, Saint Savvas Hospital, Athens, Greece Carcinoma of the oral cavity represents the eighth most common malignancy worldwide, but in some geographic areas like India, the south East Asia and Brazil, oral cancer is among the two or three most frequently encountered human malignancies. During the last thirty years the treatment of oral cancer has dramatically changed from a single treatment modality, Surgery, to a multidisciplinary therapeutic approach using Surgery along with Radiotherapy and Chemotherapy. The introduction of Combined Clinics or Tumor Boards in Universities and Hospitals that provided treatment for oral cancer patients, became a necessity and the teams of clinicians, surgeons and other scientists treating patients with oral cancer, were complimented in their therapeutic efforts with Dentists, Dietitians, Molecular Biologists and Geneticists, Reconstructive Surgeons, Pathologists, Radiologists, Psychiatrists, and several other clinical and supportive disciplines. The need for the E8

IAOO Abstract Issue creation of an international academic body to draw together all these clinicians and scientists working in the field of oral oncology became evident. The existence of such a scientific Association would primarily serve so that advances in medical science in the fight against oral cancer could be made and translated speedily into benefits for patients. Additional goals to fulfill would have been the conduct of research and educational activities for the young generations of residents and fellows working in the field of oral oncology. With those thoughts in mind, Alexander Rapidis from the University of Athens and the Greek Anticancer Institute and Crispian Scully from The University College London and the Eastman Dental Institute, whilst working together during 2004 as chairmen organizing an international congress on oral cancer, in Crete, Greece, decided to undertake such an endeavor. The concept of the International Academy of Oral Oncology, IAOO, was conceived after discussions with their mutual colleague and friend John Langdon of King’s College Hospital Medical College of London, a leading research clinician and superb surgeon from UK. The three of them confirmed that there was a real need for such a formal group and the initial inner group was completed with invitations addressed to Jatin Shah from Memorial Sloan Kettering Cancer Center in New York, USA and JeanLouis Lefebvre from the University of Lille in France to form a steering committee. This committee indentified a number of leading colleagues from around the world, active in the field of oral oncology, mostly clinicians or scientists with substantial contributions in the relevant scientific literature with publications and long lasting educational and didactic achievements. These colleagues were then formally approached personally. The first 250 contacted were unanimous in their enthusiasm for the creation of such an Academy and thus the International Academy of Oral Oncology (IAOO) was established in April 2005 in Crete, Greece. The first General Assembly of the Academy appointed Jatin Shah as it’s first President, whereas Crispian Scully was elected Secretary General, Jean-Louis Lefebvre Vice President, John Langdon Treasurer and Alexander Rapidis as Congress Chairman. During the initial phase of its existence the Academy survived financially from educational grants provided by Elsevier Medical and Merck Serono. Additionally Elsevier provided complimentary secretarial services and supportive administrative facilities that permitted the planning of its 1st World Congress scheduled to be held in Amsterdam, the Netherlands in May 2007. Rene Leemans from the Free University of Amsterdam and Jan Roodenburg from the University of Groningen chaired the Local Organizing committee. The theme of the congress was Oral cancer: a global problem. The Congress was an enormous success, being completely sold out months before the event, with more than 750 participants from all over the world. The congress was Co-organized with the World Health Organization and Professor Poul-Erik Petersen, Chief of the Oral Health Programme of WHO, presented the WHO perspective in Oral Cancer. This was the second affiliation of IAOO with WHO after the presentation of “The Crete Declaration” by the WHO in 2005 during the inaugural birth of IAOO. The Congress covered a multitude of topics representing subspecialist interests in the major sub-divisions of the field. The scientific program included keynote addresses, panel discussions, debates, instructional courses, oral papers and posters. The program was supported by a commercial exhibition, delegate receptions and a Gala Dinner. The General Assembly re-elected “The famous five” as Officers of the Academy to serve from 2007 to 2009. IAOO President Jatin Shah in his address emphasized that the aim of the Academy is to “improve the health of present and further generations by promoting excellence in research in oral oncology, objective and impartial interpretation of emerging evidence, timely application of knowledge and policies and by committing to an interdisciplinary perspective.” The 2nd World Congress of IAOO was held in Toronto, Canada in July 2009. Patrick Gullane from University of Toronto was the Congress Chair and the theme of the Congress was Oral Cancer: Imagine the Future. Elsevier again acted as Congress Organizer and the Congress was co-organized with WHO. Professor Saman Warnakulasuriya of King’s College Hospital Medical College, London UK, delivered the inaugural address on behalf of WHO, whereas more than 710 head and neck surgeons, maxillofacial surgeons, otolaryngologists, oncologists, oral pathologists and other members of the oral oncology team congregated from around the world. Coordinated by the President, Jatin Shah, and the Program Chairs, Ralph Gilbert, Alexander Rapidis, Patrick Gullane and Crispian Scully and was a huge success. The Congress covered a multitude of topics representing subspecialist interests in the major sub-divisions of the field. The scientific program included again keynote addresses, panel discussions, debates, instructional courses, oral papers and posters. The program was supported by a commercial exhibition, delegate receptions and a Gala Dinner at the Rogers Tower. The General Assembly of the Academy elected Jean-Louis Lefebvre as President of IAOO for the period E9

IAOO Abstract Issue 2009 to 2011 whereas Crispian Scully was elected as President Elect, Alexander Rapidis as Vice President, Patrick Gullane Treasurer, Luiz Kowalski of AC Camargo Hospital, Sao Paulo, Brazil as Secretary General whereas John Langdon continued to serve as Company Secretary and address all the financial and legal issues of the Academy. Jatin Shah was appointed Chairman of the Council. The 3rd World Congress of IAOO was held in Singapore in July 2011. Its theme Oral Cancer: Ying and Yang; Balancing Cures and Consequences reflected the South East Asian character of the congress site. The Copthorne Waterfront Centre, Singapore proved an excellent Congress venue and Elsevier again provided all congress logistics. The Program Chair, Khee Chee Soo of University of Singapore and Director of the National Cancer Centre of Singapore with Program Chair Christopher Goh of University of Singapore, provided an excellent scientific program that satisfied the more than 600 attendees in both the scientific and social aspects. During the General Assembly of the Academy, Crispian Scully was elected President, Jean-Louis Lefebvre immediate Past President, Alexander Rapidis President Elect, Luiz Kowalski Secretary General, Jatin Shah Chairman of the Council, Patrick Gullane Treasurer and John Langdon as Company Secretary. After the 3rd World Congress, a major re-organization in the congress Department of Elsevier Medical, resulted in their decision to disassociate their business interests with the association management and running of the Academy. This unilateral decision unfortunately coincided with the world financial crisis and resulted to a major disruption of all functions of the Academy. In an emergency meeting of the Officers of the IAOO in December of 2010, in London, UK, the Officers of the Academy took some major decisions regarding the legal status and the representation of IAOO. Until the end of 2010, IAOO was registered in the UK as Limited Company with Charity Status. This had as a consequence high solicitor fees and the costly employment of a chartered accountant. The limited income of the Academy could not bear these costs. During this emergency meeting it was decided by the Officers to transfer the Academy as a legal body to USA. The new legal existence required that IAOO should be renamed International Academy a.k.a Association of Oral Oncology, and be registered in the State of New York as a not for profit corporation. Additionally, after an international advertisement, a professional congress organizer company from Greece undertook the Association Management of IAOO, reestablished membership and took the responsibility to organize the next five world congresses of the Academy. The 4th World Congress of IAOO was held in Rhodes, Greece in May 2013. The congress was attended by 650 participants from 57 countries around the world coming from all 5 continents. President Crispian Scully and Program Chair Alexander Rapidis safeguarded another successful event. The theme of the congress, From Genes to Clinical care, reflected the interdisciplinary aspect of contemporary cancer therapy that IAOO concentrated its efforts, and to which the entirety of its Fellows believed and practiced around the world. In Rhodes the new Officers for 2013 to 2015 included Alexander Rapidis as President, Crispian Scully as Immediate Past President, Luiz Kowalski as President Elect, Moni Kuriakose as Secretary General, Patrick Gullane as Treasurer, Jatin Shah as Chairman of the Council and Jay Boyle as Executive Director. The 5th World Congress of IAOO in Sao Paulo, Brazil in July 2015, is celebrating the 10 years anniversary of the Academy. The theme, Oral Cancer: A continuing Global Challenge will emphasize the long way science, medicine and society have still to cover until the multiplicity and complexity of oral carcinogenesis is clearly identified. Luiz Kowalski has organized an exciting Scientific Program that will emphasize the interdisciplinary aspect of cancer care with relevant seminars, round tables, and sponsored events. Although the world congresses represented the epitome of the educational activity of IAOO, the Academy participated in a great number of other international congresses as a guest society. During its ten years of existence IAOO organized more than 20 events of this kind, 5 seminars and 15 panel discussions and round tables. In this way IAOO was able to be visible in similar educational events organized by other national and international scientific bodies and establish itself as a leading organization in the field of head and neck oncology. Looking back into the first decade of IAOO’s existence one can only be proud and happy for the work that has been done by the Officers, the numerous Councilors and the Fellows of the Academy. Oral cancer remains one of the most challenging oncologic problems and despite all progress in its diagnosis and therapeutic approaches, demands a tremendous interaction among team workers and collaborators for the care of patients suffering from this dreadful disease and its consequences. The multidisciplinary nature of oral cancer research and management including the disciplines of head and neck surgery, otolaryngology, maxillofacial surgery, plastic surgery, medical oncology, radiation oncology, pathology, dentistry, epidemiology, basic and translational science, speech therapy, E10

IAOO Abstract Issue nutrition and nursery is of outmost importance and will certainly remain unchanged for at least the next thirty years. The current generation of leaders in head and neck oncology that dominated IAOO since its birth are stepping down one by one, and our former students, residents and fellows are taking our places. This evolution is not only welcomed but also expected and demanded. It is important that future events of the IAOO will be designed in such a way that they will continue to provide unbiased and detailed evidence or data that can be effectively and confidently translated into clinical practice. All IAOO congresses and related events were s o f a r successful, stimulating and interesting highlighting the continuing need for high-quality research into the biology and treatment of head and neck cancer. The IAOO Officers and Councilors will continue to strive to improve health for present and future generations through an interdisciplinary perspective, objective, impartial interpretation of emerging evidence and timely application of knowledge and policies.

ORAL  PRESENTATIONS  

OP001. ORGAN PRESERVATION WITH DAILY CONCURRENT CHEMORADIOTHERAPY USING RETROGRADE SUPERSELECTIVE INTRA-ARTERIAL INFUSION FOR STAGE III, IV ORAL CANCER: ANALYSIS IN 112 CASES Iwai Tohnai1, Kenji Mitsudo1, Mitomu Kioi1, Toshiyuki Koizumi1, Senri Oguri1, Toshinori Iwai1, Hideyuki Nakashima1, Makoto Hirota1 1. Department of Oral and Maxillofacial Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan. Background: Retrograde superselective intra-arterial chemotherapy for oral cancer has the advantage of delivering a high concentration of the chemotherapeutic agents to the tumor bed, it can be used to provide daily concurrent chemoradiotherapy for patients with advanced oral cancer. The purpose of this study was to evaluate the therapeutic results and rate of organ preservation in 112 patients of stage III or IV (M0) oral cancer treated with retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy. Methods: Between August 2006 and July 2011, 112 patients with stage III or IV oral squamous cell carcinoma underwent intra-arterial chemoradiotherapy. Catheterization from the superficial temporal and occipital arteries was performed. And treatment consisted of superselective intra-arterial chemotherapy (docetaxel, total 60 mg/m2, cisplatin, total 150 mg/m2) and daily concurrent radiotherapy (total 60 Gy) for 6 weeks. Results: The median follow-up for all patients was 46.2 months (range, 10–90 months). The median follow-up for living patients was 49.7 months (range, 36–90 months). After intra-arterial chemoradiotherapy, primary site complete response was achieved in 98 (87.5%) of 112 cases. Thirty patients (26.8%) died. Using the Kaplan-Meier method, 3-year, and 5-year survival rates were 74.6% and 71.3%, respectively, while 3-year, and 5-year local control rates were both 79.3%. Grade 3 or 4 toxicities included mucositis in 92.0%, neutropenia in 30.4%, dermatitis in 28.6%, anemia in 26.8%, and thrombocytopenia in 7.1%. Grade 3 toxicities included dysphagia in 72.3%, nausea/vomiting in 21.4%, fever in 8.0%, and renal failure occurred in 0.9%, no patients died as a result of treatment toxicity. Conclusions: Retrograde superselective intra-arterial chemotherapy and daily concurrent radiotherapy for Stage III, IV oral cancer provided good overall survival and local control rates, thus preserving organs and contributing to patients’ QOL. E11

IAOO Abstract Issue OP002. RADIOTHERAPY, GEMCITABINE, AND CETUXIMAB (RAGE) AFTER INDUCTION CHEMOTHERAPY (ICT) IS A MANAGEABLE AND PROMISING THERAPY FOR PATIENTS WITH LOCOREGIONALLY ADVANCED SQUAMOUS CELL CARCINOMA OF THE HEAD AND NECK (LASCCHN). Pol Specenier1, Danielle Van den Weyngaert2, Dirk Van Gestel2, Carl Van Laer3, Olivier Vanderveken3, Caroline Verschueren1, Jan B Vermorken1. 1. Antwerp University Hospital, Department of Oncology, Edegem, Belgium. 2. ZNA, Department of Radiotherapy, Antwerp, Belgium. 3. Antwerp University Hospital, Department of Otolaryngology, Edegem, Belgium Introduction: Chemoradiation is the standard of care in LA-SCCHN. Gemcitabine and cetuximab are potent radiosensitizers. Purpose: to study the feasibility of RAGE in LA-SCCHN. Methods: Eligible: LA-SCCHN patients qualifying for definitive chemoradiation. Treatment: cetuximab: 400 mg/m² 1 week before radiotherapy, 250 mg/m² weekly during RT; gemcitabine 10 mg/m² weekly during RT (32 fractions, 5 fractions/week, up to 69.12 Gy, simultaneous integrated boost technique). Results: Twenty five (25) patients (23 male) were treated with RAGE after ICT (4/2010-4/2014). Median age: 63 years (range: 47-74). Tumor sites: hypopharynx 7; oropharynx 9; supraglottis 3; maxillary sinus 2, oral cavity 1, unknown 3. Stages: T4N2c (n=4), T3N2b (n=4), T4N2b (n=3); TxN3 (n=3), T4N1 (n=2), T3N2c (n=2), T2N2b, TxN2b, T2N3, T3N0, T3N1, T3N3, T4N3 (1 each). ICT: 6 x weekly carboplatin (AUC 2)/paclitaxel (70 mg/m²): 3; TPF: 21 (4 cycles: 17; 3 cycles: 1; 1 or 2 cycles èweekly carboplatin/paclitaxel: 3), 4 x docetaxel, 5-FU, carboplatin: 1. Radiotherapy duration: median: 43 days (range: 42-47). 24/25 received the planned radiotherapy, 23/25 planned gemcitabine and cetuximab. Patients received > 97 % of planned gemcitabine and cetuximab without delays. Toxicity: (number of patients, maximum grade [NCI-CTC version 4]): radiodermatitis: 2 grade 1, 9 grade 2, 12 grade 3, 2 grade 4; mucositis: 1 grade 2, 23 grade 3, 1 grade 4. Weight loss: 6: < 5%; 11 5-30% reduction in maximum dimension) on CT/MRI and later PETCT imaging analysis in all cases. Pain diaries have shown improved symptom control and the often-offensive odour associated with advanced fungating lesions improved or disappeared improving quality of life. Two patients died shortly after treatment, due to the advanced state of their disease. Conclusions: Data suggests that ECT may offer an acceptable and effective treatment for some patients who may have few or no other treatment options. OP125. RESPONSE & TOXICITY CORRELATION WITH TOTAL RADIATION DOSE & RADIOSENSITIZER USED IN INOPERABLE OROPHARYNGEAL/ORAL CAVITY CANCERS Adil Allah Rakha1, Abdul Mateen1, Durre Sabih1, Misbah Masood2, Kamran Saeed2 1. MINAR, Nishtar Hospital, Multan, Pakistan 2. INMOL Cancer Hospital, Wahdat Road, Lahore, Pakistan Objective: This is an on going prospective study with the objective to assess patient and tumor related characteristics, assess overall response of treatment, incidence and trend of radiation related side effects and their correlation with concurrent radio-sensitizer and total radiation dose delivered in head and neck cancer. Methods: Data of 29 patients with oral cavity or oropharyngeal malignancy who were either primarily inoperable or were refused surgery treated with either concurrent cisplatin or cetuximab based chemoradiotherapy or radiation alone was analyzed prospectively. Patients were categorized in to two groups. Group one included (23 patients) those who were given both radiotherapy as well as concurrent chemotherapy while group-2 (6 patients) included only those with low performance status and thus were considered not fit enough to tolerate concomitant chemotherapy. In the group-1A, majority of the patients (87%) receiving chemotherapy were given concurrent weekly cisplatin while rest of the (13%) patients (Group-1B) received weekly cetuximab The distribution of the disease stage was as follows: Stage- II (all of posterior tongue) 5 patients, Stage III (node positive) 7 patients, Stage IVA, 12 patients; Stage IVB 5 patients. Patients were treated with total radiotherapy dose of 66Gy + weekly fixed dose Cisplatin 50mg or Cetuximab 300mg 1 hour before radiotherapy. Results: Over all response of treatment (by the end of one month after treatment) was observed in 97% of our patients. Complete clinical response was noticed was 57% and 77% in group-1A and group1B respectively where as in the group-2, it was observed in only 30% of patients. Commonest side effects obsereved in our patients were mucositis, xerostomia, malaise, skin blackening, change of taste. Mucositis and Xerostomia are the most frequent of these. Grade 3 mucosal toxicity was observed in 18 patients. Major grade-4 toxicity observed was mucositis and xerostomia which (each) was noted in 5 patients. These toxicities were more commonly seen in patients who were given concurrent chemotherapy with cisplatin and those with Hb < 12gm/dl (r = -0.448) at the start of radiotherapy treatment. None of the patient receiving total radiotherapy dose below 66Gy developed any grade 4 toxicity (P = 0.0061). At the time of final data analysis (4.5 months post first radiotherapy fraction), 4 out of 18 (22%) patients became hypothyroid due to the effects of neck radiotherapy and all these were those who received radiation dose in excess of 66Gy. E74

IAOO Abstract Issue Conclusions: As compared with cisplatin, concurrent cetuximab based chemotherapy is more effective and less toxic. Incidence and severity of radiation related side effects is slightly high in our patients. Total radiotherapy dose, hemoglobin level and concurrent chemotherapy do affect compliance of the patient to radiation treatment. Patients receiving radiation doses in in excess of 66 Gy to the neck area should undergo an early evaluation of their post-irradiation thyroid functions. Key Words: concurrent chemotherpy, radiation therapy, acute radiotherapy effects, hypothyroid OP126. IMAGING ACUTE TUMOR LACTATE PERTURBATIONS AS A BIOMARKER OF GENOTOXIC STRESS Vlad C. Sandulache, Yunyun Chen, Heath D. Skinner, Laurence E. Court, James A. Bankson, Stephen Y. Lai The University of Texas M.D. Anderson Cancer Center, Houston, Texas, U.S.A Introduction: Ionizing radiation (IR) and some chemotherapeutic agents induce tumor cell death through genotoxic stress. Perturbations in cellular reactive oxygen species (ROS) are essential for therapeutic response. We have shown that ROS-driven perturbations in cellular reducing potential impact metabolic activity. Purpose: We hypothesize that changes in cellular lactate levels can reflect acute genotoxic stress. These alterations can be measured biochemically and through non-invasive imaging studies. Method: Sensitivity to specific agents and IR was assayed by measuring ROS levels and cell survival. Biochemical assays were used to assess lactate and NADH/NAD+ levels. Using murine orthotopic xenograft models of head and neck cancer, we examined changes in tumor metabolism following targeted pharmacologic inhibition or exposure to IR using [1-13C] pyruvate in hyperpolarized magnetic resonance imaging (HP-MRI). Results: Radiation and cisplatin induce a rapid and transient increase in intra-cellular ROS levels and a compensatory decrease in the cellular NADH/NAD+ ratio. Consistent with an oxidative stress mechanism, N-acetyl cysteine (NAC) reversed effects on the NADH/NAD+ ratio in a dose-dependent manner. This pattern was mimicked by exposure to IR or cisplatin and also reversed by NAC. Acute perturbations in cellular lactate levels were dose dependent and returned to baseline within 2 hours. HP-MRI could detect acute changes in tumor metabolism after exposure to 2-deoxyglucose (2-DG; p 5.0 mg/L, hemoglobin < 12 g/dL or serum albumin < 3.2 g/dL). Results: 46 pts were studied, median age 61 y.o. (44-78 y.o.), 31 (67%) male. Median BMI was 23.8 kg/m2 (17.1-34.3 kg/m2). Dysphagia was a complaint in 36 pts (78%). Weight loss ≤ 5% in the previous year occurred in 10 pts (21.7%). Reduced muscle strength was seen in 4/24 pts (17%), fatigue in 23/43 pts (53%), anorexia in 16/41 pts (39%), low LBM in 32/40 pts (80%) and any laboratorial alteration in 22/41 pts (53%). Cachexia was diagnosed in 4/34 pts (10.5%). When we did not consider the weight variations in the previous year, other alterations were diagnosed in 15/33 pts (45.5%). Conclusions: Cachexia features were frequently diagnosed in OSCC pts with NED in a long-term followup after CCR. OP129. SALIVARY MICRORNAS AS PREDICTORS OF LONG-TERM GOOD OUTCOMES IN ORAL/OROPHARYNGEAL SQUAMOUS CELL CARCINOMA PATIENTS TREATED WITH CISPLATIN-BASED CHEMORADIATION Fabyane Oliveira Teixeira Garcia1, Vivian Marinelli Constantino2, Milena Perez Mak3, Alex Vitorio Amadio1, Rosimeire Aparecida Roela1, Gilberto de Castro Junior3, Fatima Solange Pasini1. 1. Centro de Investigação Translacional em Oncologia, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil 2. PAP do Sistema HC/FMUSP, programa Marcadores Moleculares em Tumores Sólidos (LIM24), Departamento de Radiologia e Oncologia Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil 3. Serviço de Oncologia Clinica, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, BRAZIL E76

IAOO Abstract Issue Introduction: Salivary microRNAs (miRs) are easily accessed and are being under investigation as prognostic and predictive biomarkers in head & neck cancer patients. Purpose: Here we analyzed changes in salivary miRs from oral/oropharyngeal squamous cell carcinoma (OSCC) patients in response to cisplatin-based chemoradiation and whether the miRs are contained within exosomes. Method: Eleven healthy volunteers and 39 OSCC patients in three groups: treatment naïve (group 1, N=19), after treatment failure (group 2, N=7), and disease free patients for at least 2 years (group 3, N=13) were included. The miR21-5p, miR15a-5p, miR200b-3p and miR296-5p were chosen to be analyzed by qRT-PCR and the miR16-5p was used for normalization. The miR-21-5p was also determined in exosomes isolated from 6 samples. Non-parametric tests were used to compare the groups. Results: Groups 1 and 3 showed an increased expression of miR-21-5p, miR-15a-5p and miR-200b-3p as compared to healthy volunteers. Lower expression of miR-21-5p and miR-200b-3p (p=0.05;0.08) was observed in group 2 compared to group 1. Furthermore, the expression of these two miRNAs was higher in group 3 compared to group 2 (p=0.015). miR-296-5p expression was not detected in almost all samples. Transmission electron microscopic images of isolated microvesicles exhibited vesicles compatible with exosomes (30-120 nm). Moreover, in 4/6 samples, miR-21-5p expression in isolated exosomes comprised around 60% of the total salivary miR content. Conclusions: Salivary miR21-5p and miR200b-3p may be associated with long-term good outcomes after cisplatin-based chemoradiation. Supported by FAPESP (2013/253970). OP130. INTENSITY-MODULATED RADIATION THERAPY-RELATED UNSUAL HYPERPIGMENTATION OF THE TONGUE: REPORT OF TWO CASES. Wagner Gomes da Silva¹, Aristília Pricila Tahara Kemp¹, Ana Carolina Prado Ribeiro¹, Alan Roger Santos Silva², Marco Aurélio Vamondes Kulcsar³, Gilberto Castro Junior4, Gustavo Nader Marta5, Thais Bianca Brandão¹ 1. Dental Service, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil 2. Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas, São Paulo, Brazil 3. Head and Neck Surgery Department, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil 4. Clinical Oncology Department, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil 5. Radiation Oncology Department, Instituto do Câncer do Estado de São Paulo (ICESP), University of São Paulo, São Paulo, Brazil Introduction: Several well-known acute and late toxicities on oral tissues within radiation field have been reported in association with radiotherapic treatment of head and neck malignant conditions. Oral pigmented lesions have been related with racial melanosis, locally irritants, tobacco, dental restorations, lichen planus, melanocytic lesions, syndromes, systemic disorders and a variety of drugs, among others. Purpose: Herein we report two unusual cases of hyperpigmentation of the tongue in African American female patients with salivary gland-type malignant tumors involving the palate/sinonasal tract following intensity-modulated radiation therapy (IMRT). Method: Both patients presented asymptomatic brownish stained macules affecting the dorsum and lateral borders of the tongue after the middle of treatment. Results: In the first case, the macules had disappeared 1 month after the conclusion of radiotherapy and, in second one, it has faded significantly after 5 months, however it still remains. There were no other evident medical conditions, local or systemic causes as well as no known drugs previously associated with oral pigmentation that could explain these atypical findings. Conclusion: Although no relevant clinical issues seem to affect these patients, the knowledge of this apparent unreported radiation side effect by oral care providers and supportive care in cancer teams is of great value to properly guide patients undergoing head and neck radiotherapy. Additionally, the E77

IAOO Abstract Issue understanding about its pathogenesis is important in the differential diagnosis to rule out other pigmented lesions of the oral mucosa. OP131. ORAL CANCER: COMMUNITY BASED RANDOMIZED SCREENING VERSUS HIGH RISK PATIENT SCREENING: IMPACT OF THE IMPLEMENTATION OF A PERMANENT NETWORKING MODEL OF SCREENING Luciana Vieira Muniz1, Joao Marcos Arantes Soares2, Rodrigo Mendonça Ribeiro Batista1, Altair Oliveira3, Raphael Abreu Sepulcri2, Sara Lemos3, Rosy Iara Maciel de Azambuja Ribeiro4, Aline Lauda Freitas Chaves5 1. Department of Dentistry - Association Against Cancer of the Midwest Mine, Divinópolis, MG, Brazil 2. Department of Medicine - Federal University of São João del Rei, Divinópolis, MG, Brazil 3. Department of Prevention - Association Against Cancer of the Midwest Mine, Divinópolis,MG,Brazil 4. Laboratory of Experimental Pathology -Federal University of São João del Rei, Divinópolis,MG,Brazil 5. Department of Clinical Oncology - São João de Deus Hospital, Divinópolis, MG, Brazil Introduction: the oral cancer is a health problem due to high incidence, morbidity and mortality. Fast diagnosis is essential to promote an efficient treatment. Purpose: to compare the results of two screening program in our region in Brazil, with 1.200.000 inhabitants. Methods: Between 2007 and 2014 we performed two parallels oral cancer screening program: 1) random screening community based; 2) a model based in training health professionals (dentist, nurses and community health agents) in primary and secondary oral cancer prevention. Dentists were trained to recognize suspicious lesions and refer the patient to the Cancer Hospital. The patient were re-examined by the expert dentist in cancer hospital, who performed the biopsies if necessary. Results: In the community based screening program 1059 people were analyzed and two premalignant lesions were diagnosed. In the new networking model 1500 people were analyzed in which 89 people were diagnosed with malignant lesions (61 male, 28 female), age between 19-92 years. Conclusion: The model of permanent networking model integrated with other health services and institutions showed greater proficiency and resolution compared to population-based screening programs. OP132. ORAL CANCER SCREENING ASSOCIATED WITH REDUCED MORTALITY – A POPULATION BASED FOLLOW-UP STUDY Pei-Shan Ho1, Yi-Hsin Yang2 1. Department of Oral Hygiene, Kaohsiung Medical University, Kaohsiung, Taiwan 2. School of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan Introduction: Morden techniques provide various strategies for oral cancer screening. While patients can be diagnosed at earlier stages, the quantitative benefits can provide important information toward planning of screening programs. Purpose: This study aim is to investigate the survival benefit of oral cancer screening in oral cancer patients. Method: This study population is based on the Cancer Registry (CR) and the Health Insurance Research Database (NHIRD) in Taiwan. Dates and causes of death were confirmed by Death Registry. Descriptive statistics, Kaplan-Meier survival curves and Cox regressions were used for statistical analysis. Results: A number of 15,935 newly diagnosis oral cavity cancer patients was retrieved by ICD-9-CM (140-141, 143-145) and ICD-C-O (C00-C06) during 2007-2010. Among them 24.65% of patients who had records of oral cancer screening prior to their cancer diagnosis dates were identified through NHIRD. The screened patients were diagnosed at earlier cancer stages than other patients (p0.05. Majority of patients opted the electrolarynx (40.0% and 60.0%). Voice Activity Participation Profile score were 52.9% and 54.6%, p>0.05. Conclusions: MR, PLCO and FJ flap should be considered in the surgical management of patients with isolated PE tumours.

OP214. CLINICOPATHOLOGIC CHARACTERISTICS AND OUTCOMES OF RECURRENT P16 POSITIVE OROPHARYNGEAL CARCINOMA Chase M. Heaton, Karina Yu, Steven J. Wang University of California – San Francisco, Department of Otolaryngology – Head and Neck Surgery, San Francisco, CA, U.S.A Introduction: p16 is a surrogate for HPV-positive oropharynx cancers and is predictive of improved survival and response to treatment. There is limited study on patients with p16+ oropharynx cancer who fail initial treatment. Purpose: To compare clinicopathologic characteristics and outcomes of recurrent p16+ and p16oropharyngeal carcinomas. Methods: This case series included all cases of recurrent oropharyngeal carcinoma at our institution from 2002 to 2014. Results: Forty patients met inclusion criteria. Thirty-one (77.5%) tumors were p16+ and 9 (22.5%) were p16-. All p16- tumor patients smoked, while 18 (58%) p16+ tumor patients smoked (p=0.017). All p16- tumors were tonsil, while 13 (41.9%) were tonsil and 19 (58.1%) were base of tongue (p=0.001) in the p16+ group. There was no difference in T-status at diagnosis (p=0.273); however, more patients with p16+ tumors presented initially with ≥N2 nodal disease (p=0.049). Regional and/or metastatic recurrence was more common in the p16+ group as compared to the p16- group – 22 (71%) vs 2 (22.2%), p=0.018. Outcomes for both groups were poor – 12 (67.7%) p16+ and 4 (44.4%) p16patients either died from disease or had persistent disease at last follow-up. Conclusions: A majority of recurrent oropharyngeal cancers are p16+. Compared to p16- recurrent tumor patients, p16+ recurrent tumor patients were less likely to smoke, more likely to have a base of tongue primary, more likely to present initially with advanced nodal disease, and more likely to experience regional or distant metastatic recurrence. Overall outcomes for both p16+ and p16- recurrent oropharynx tumors was poor.

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IAOO Abstract Issue OP215. APPLICATION OF VASCULARIZED FREE FLAP IN THE RECONSTRUCTION OF SKULL BASE DEFECT AFTER TUMOR ABLATION Lei Zhang, YuxingGuo, Chuanbin Guo Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology. Beijing, China Objective: To explore the application of microvascular free flap in the reconstruction of skull base defect after tumor ablation. Materials and methods: Ten patients (M:3, F: 7, Age: 35-64 with median age 47)with skull base tumor were admitted to the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from Jan. 2008 to Aug. 2014. Reasonable kind of microvascular free flap was used to reconstruct the defects of cranial base after tumor ablation. Data related to the survival of the flaps and complications were collected. Follow-up was performed to evaluate the postoperative appearance and function of patients and the tumor recurrence. Results: Ten patients with cranial base tumor were operated in this series with 6 kinds of pathology results. Different kinds of vascularized free tissue flap were used to reconstruct the large defect related to the skull base, including 7 ALTP, 1 Forearm, 1 Fibula and 1 DIEP. All of the 10 flaps were success without serious complications of donor and recipient site. Postoperative cerebrospinal fluid fistula happened in 2 cases, which was remitted by itself in 1 case and by lumbar cistern drainage in another case with the help of the neurosurgery. Postoperative function on breathing, eating, pronunciation recovered smoothly in the 1-46 months followed up period. Patients were satisfied with the postoperative appearance. Conclusion: Microvascular free flap is a safe and reliable method to reconstruct the large defect after skull base tumor resection. Appearance and function recovery can be obtained. More attention should be pay on the cerebrospinal fluid fistula due to the dural defect after the tumor ablation. Suitable flap was selected according to the the range and volume of tissue defect, obliteration of dead space. Keywords: Skull base defect,Vascularized free flap

OP216. SURGICAL APPROACHES TO ANTERIOR AND MIDDLE SKULL BASE Gui-qing Liao, Yu-xiong Su, Guang-sen Zheng, Si-en Zhang Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China Objectives: The complex anatomical structure that the tumor resection and postoperative reconstruction of the skull base involved is the main emphasis and difficulty of the multidisciplinary research of skull base surgery. There are various surgical approaches to the anterior and middle skull base and each has its own characteristic, but the indications of each approach remain controversial. This study aimed to determine the suitable approaches to various anterior and middle cranial base. Methods: The surgical approaches to tumor located in cranial base and endo-exocranial communication area in recent years were reviewed. In addition, respective advantages and disadvantages of these approaches were compared in the aspects of exposure of tumor, the protection of nerves and blood vessel,postoperation complications and quality of life of patient. Results: Coronal incision with unilateral or bilateral frontal craniotomy is a suitable access to tumor at the base of of anterior cranial fossa that involves the ethmoid sinus, sphenoid sinus, orbit and preglabellar area. Webber incision with maxillary swing approach provides the maximum direct exposure for anterior and middle skull base tumor that involves the base of orbit, sphenoid sinus and pterygopalatine fossa. The infratemporal fossa mastoid approach suits to lesions in the jugular foramen region. If the exocranial part of tumor is large and involves parapharyngeal, the mandibular swing approach should be considered, especially to benign tumor. The orbitozygomatic fronttemperal approach is suitable for the tumor extending prominently into the anterior and middle cranial base. Transoral transposteriorwall pharynx is proper for tumor of clivus of the skull base and posterior pharyngeal wall. Conclusion: According to our study, choosing surgical approach as above can provide better tumor exposure,protection of nerves and vessels,improvement of quality of life and decrease the complications, especially when the tumor is large. E121

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OP217. PROGNOSIS OF SKULL BASE TUMORS Riaz Ahmed Department of Oral & Maxillofacial Surgery, King Edward Medical University Lahore, Pakistan Objectives : To evaluate outcomes of surgical management of oral and maxillofacial pathologies extending upto skull base. Material and method: Retrospective data collection ,from July 2000 to June 2011 (10 years). Total 83 patients were in this study .Data regarding demographic, pre-operative ,operative, post-operative, and follow up to 5 years (range 10 -61 months) were collected. Results: Skull base tumours have satisfacory prognosis. Nasopharyngeal Angiofibroma even in younger age group have good prognosis. Lefort I osteotomy has satisfactory access and prognosis. OP218. MASH1 EXPRESSION CLOSELY CORRELATES WITH ENDOCRINE PHENOTYPE AND DEGREE OF DIFFERENTIATION IN SINONASAL NEUROENDOCRINE TUMORS Melissa Taggart, Randal Weber, Ehab Hanna1, Diana Bell Departments of Pathology and Head and Neck Surgery, MD Anderson Cancer Center, Houston, U.S.A. Background: Primary sinonasal tumors with neuroendocrine differentiation (SCND) are uncommon tumors with overlapping histological features. Based on the amount of neuroendocrine differentiation, they can be subcategorized into sinonasal undifferentiated carcinoma (SNUC), sinonasal high-grade neuroendocrine carcinoma/ small cell carcinoma (HG-NEC/SmCC), and esthesioneuroblastoma (ENB). The natural history and biological behavior varies in this group of tumors. Hence the morphological diagnosis coupled with grading/staging is important for prognostication. The mammalian achaete-scute homologue (mASH-1) is crucial for early development of the sympathetic nervous system and is transiently expressed in sympathetic neuroblasts during embryogenesis, likely contributing to differentiation and growth regulation of these cells. Thus, expression of MASH1 may provide a useful marker for cancers with neuroendocrine features. The aim of this study was to compare and assess the value of MASH1 protein expression/ levels in sinonasal neuroendocrine tumors. Methods: We reviewed the morphologic features and performed immunohistochemistry for MASH-1 on FFPE samples of 30 surgically resected cancers with neuroendocrine differentiation from our institution comprising 10 SNUCs, 5 HG-NEC/SmCC, 12 ENBs (3 high-grade, 9 low-grade), and 3 H&N NEC outside the sinonasal region (1 recurrent middle ear carcinoid tumor, 1 moderately differentiated NEC of parotid, 1 metastatic medullary thyroid carcinoma). Staining for MASH-1 was designated negative, focal, patchy or diffuse positivity when nuclear staining was detected in 0%, < 10%, 10-50%, or > 50% of the tumor cells, respectively. Results: Of the 10 SNUCs, four cases showed patchy MASH1 expression and one case had focal MASH1 (50% SNUC expressed mASH1). All HG-NECs were diffusely positive for MASH1 (100% MASH1 expression). Of the high-grade ENB, 2 were diffusely positive and one focally positive (100 % MASH1 expression). Of the low-grade ENB, three showed patchy positivity, four stained focally and 2 were negative (70% mASH1 expression). The recurrent middle ear carcinoid tumor was diffusely positive while the moderately differentiated NEC of parotid and metastatic medullary thyroid carcinoma showed patchy positivity for MASH1. Conclusions: Our data confirmed the findings that MASH1 is specifically expressed in sinonasal cancers with neuroendocrine differentiation, indicating that besides being instrumental in the development of a subset of neurons and neuroendocrine cells, MASH1 plays a key role in regulating neuroendocrine differentiation in tumor cells. This study also indicates that MASH1 expression levels are inversely associated with the degree of tumor differentiation (high-grade tumors show increased expression of this protein), which correlates well with studies indicating that expression of MASH1 appears to be restricted to immature cells.

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IAOO Abstract Issue OP219. ADVANCES IN THE MANAGEMENT OF RECURRENT NASOPHARYNGEAL CARCINOMA Jimmy Yu Wai Chan Division of Head & Neck Surgery, University of Hong Kong, Hong Kong, China Introduction: Persistent and recurrent nasopharyngeal carcinoma after previous radiotherapy is commonly treated by salvage surgery. While small tumours in favorable locations can be removed by the endoscopic, or more recently, trans-oral robotic assisted approach, large tumours with bony and parapharyngeal space invasion are commonly resected via the open approach. Purpose: To investigate the rate of local recurrence, survival and morbidities after surgical salvage for recurrent nasopharyngeal carcinoma Method: Prospective study recruiting patients with recurrent nasopharyngeal carcinoma who underwent nasopharyngectomy between 1984 and 2014. Results: In the study period, 462 patients received nasopharyngectomy for recurrent nasopharyngeal carcinoma, among which, 93.9% had the operation performed via the Maxillary Swing approach. 5-year actuarial local tumour control was 65%. 5-year overall survival for recurrent stage I, stage II, stage III and stage IV tumour was 84%, 65%, 52%, 48%, respectively. The mean hospital stay was 8.2 days and all patients can resume per oral feeding upon discharge. The commonest post-operative morbidities were trismus, facial numbness and hearing problem. Over the years, we have modified the surgical techniques that effectively reduced the incidence of palatal fistula from 24.0% to 3.7%. Collaborating with the speech therapist, we have adopted an aggressive physiotherapy and mouth- opening exercise early after surgery and the risk of post-operative trismus has reduced from 42.1% to 9.2%. Conclusions: Surgical salvage is effective for recurrent nasopharyngeal carcinoma. Post-operative morbidities can largely be prevented by a combination of measures from intra-operative attention to details and meticulous techniques to post-operative education and early aggressive physiotherapy. OP220. COMPUTER AIDED NAVIGATION TECHNIQUE IN THE MANAGEMENG OF SKULL BASE TUMORS Chuanbin Guo, Xiaojing Liu, Yuxing Guo Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China Tumors in the skull base are difficult to manage because there are some “dangerous” structures in this deeply hidden place. Computer aided navigation (CAN) technique is an effective way to improve the safety and accuracy of surgery in this difficult space. CAN is a kind of special instruments, which are connected to the navigation system to touch an anatomical position on the patient. This position is simultaneously shown in the images taken from this patient. The surgeon can thus use the instrument to ‘navigate’ the images of the patient by moving the instrument. In this presentation, clinical work flow of CAN in the management of skull base tumors was introduced. Its clinical application included two parts: navigation–guided operation in skull base tumors and navigation-guided needle biopsy for skull base lesions. Typical cases were presented in details to show our experiences in using this technique for handling skull base tumors. OP221. BENIGN AND MALIGNANT LESIONS OF SALIVARY GLANDS IN PAKISTAN: SIX-YEARSDATA (2009-2014) Syed Muhammad Ali Naqvi1, Muhammad Asif Qureshi2, Talat Mirza3, Tazeen Mustansar3 ,Anwar Ali4 1. Dr.Ishrat ul Ebad Khan Institute of Oral Health Sciences (DIKIOHS), Dow University of Health Sciences (DUHS), Karachi. 2. Department of Pathology, Dow International Medical College( DIMC), Dow University of Health Sciences (DUHS), Karachi. 3. Department of Histopathology, Dow International Medical College (DIMC), Dow University of Health Sciences (DUHS),Karachi. E123

IAOO Abstract Issue 4. Oral & Maxillofacial Surgery Department, Dr.Ishrat ul Ebad Khan Institute of Oral Health Sciences (DIKIOHS), Dow University of Health Sciences (DUHS), Karachi. Introduction: Data regarding spectrum of salivary gland lesions is scanty in Pakistan. This study will therefore pool data into national and international statistics for salivary glands disorders. Purpose: To describe Pathology based spectrum of salivary gland-lesions in Pakistani population. Methodology: The study was conducted at the Department of Histopathology; Dow diagnostics, reference and research laboratory (DDRRL) Karachi, the largest government based reference laboratory of Sindh, Pakistan. All salivary gland lesions received at the laboratory during 2009-2014 were included in the study. Results: A total of 370 samples were investigated. Of these, a total of 104(28%) were non-neoplastic and 266(72%) were neoplastic lesions. Out of 104 non-neoplastic lesions, 61 cases (58.6%) were inflammatory and 43 (41.3%) were mucoceles. Out of 61 inflammatory lesions, chronic sialadenitis, 48(78.6 %) was the most common condition. Submandibular gland was the most common effected site. For mucoceles, lower lip was the most common site. Of the 266 neoplastic lesions, 209 (78.5%) were benign while 57 (21.4%) were malignant. Pleomorphic adenoma was the commonest benign lesion, 188 (89.9%) where parotid gland effected in majority, 132 (70.2%). In malignant tumours, 21 cases (36.8%) of Adenoid cystic carcinoma were the most common malignant lesion. Mucoepidermoid carcinoma, 18 cases (31.5%) was the second most common malignant lesion. In former submandibular gland effected in majority followed by parotid gland in latter malignant lesion. Conclusion: Chronic sialadenitis was the most common non-neoplastic lesion, pleomorphic adenoma was the most common benign lesion and adenoid cystic carcinoma was the most common malignant lesion. Keywords: Chronic Sialadenitis, Mucoceles, Pleomorphic Adenoma, Adenoid cystic carcinoma, Mucoepidermoid carcinoma, Parotid gland, Submandibular gland OP222. CHROMOSOMAL MICROARRAY ANALYSIS (CMA) OF PAROTID GLAND PLEOMORPHIC ADENOMA Esther Manor, Shirley Amar, Ben-Zion Joshua, Lipa Bodner Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel Cytogenetic analysis of pleomorphic adenoma (PA) arising in the parotid gland, is well documented with chromosome 8 being the most commonly involved. About 70% of the PA cases cary abnormal katyotypes , with non-random involvement of 8q12, the locus of pleomorphic adenoma gene PLAG1. Highly specific chromosome translocation, namely t(3;8)(p21;q12), and other abnormalities such as 12q13-15 rearrangements and trisomy 8 have also been reported. Chromosomal microarray assay (CMA) , revealed novel regions of interest in PA. Losses of chromosomes 12q, 16, 17, 22 and gains in chromosomes 4q, 5q, 6q, 13q were reported. Deletions in the short arm of chromosome 9 and deletions on the short arm of chromosome 1 were also reported Despite all these findings , the tumorigenesis of PA is still not well understood. The purpose of the current study was to report the results of CMA of parotid gland PA , which looks like a balanced reciprocal t(12;18)(q13-15;q12.1) translocation. OP223. AUTOPHAGY: A NEW TARGET FOR THE TREATMENT OF SALIVARY GLAND ADENOID CYSTIC CARCINOMA Yu-Xiong Su1, Gui-Qing Liao2, Li-Zhong Liang2, Ben Ma2 1. Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, the University of Hong Kong, Hong Kong 2. Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China E124

IAOO Abstract Issue Introduction: Our previous studies found that expression of Beclin 1 and other autophagy related genes in salivary gland adenoid cystic carcinoma (ACC) was lower than tumor-adjacent normal tissue. Beclin 1 protein and mRNA expression were independent prognostic factors for ACC patients. We hypothesized that autophagy may influence chemosensitivity and radiosensitivity of ACC. Purpose: To investigate the role of autophagy in radiotherapy and chemotherapy of salivary gland ACC. Method: The autophagy level and the expression of Beclin 1 were investigated when ACC cells treated with Obatoclax, Cisplatin, radiation, or Cisplatin+ radiation. Then the cytotoxicity was evaluated when down-regulating or up-regulating expression of Beclin 1, with or without pharmacologically inhibiting autophagy level or apoptosis activity. Results: Obatoclax increased autophagy level and expression of Beclin 1 in ACC cells. These effects were suppressed by 3-MA or CQ. Autophagy level was decreased when suppressing Beclin 1 expression. When autophagy was suppressed by Beclin 1 shRNA, 3-MA or CQ, sensitivity to Cisplatin of ACC cells was significantly increased. However radiosensitivity of cells decreased when autophagy was suppressed. Conclusions: Autophagy participates in responding to chemotherapy and radiation of human salivary gland ACC cells. Regulation of autophagy level can influence chemosensitivity and radiosensitivity of ACC cells. These findings indicated regulating of autophagy would be a new therapeutic strategy for salivary gland ACC. OP224. MICRORNA PROFILES IN SALIVARY GLAND TUMORS Cláudia Malheiros Coutinho-Camillo1, Renato David Puga2, Cibele Pidorodeski Nagano3, Yukie SatoKuwabara1, Felipe D’Almeida Costa1, Clóvis Antonio Lopes Pinto1, Luiz Paulo Kowalski4, Fernando Augusto Soares1,3, Silvia Vanessa Lourenço3 1. Department of Pathology, AC Camargo Cancer Center, São Paulo, Brazil 2. Hospital Israelita Albert Einstein- HIAE, São Paulo, Brazil 3. Department of General Pathology, Dental School, University of São Paulo, Brazil 4. Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center , São Paulo, Brazil Introduction: Mucoepidermoid carcinoma (MEC) is the most common malignant tumor of the salivary glands, especially affecting the parotids. Histological grading (low, intermediate, and high) is of recognized prognostic importance. This is based on the architectural formation, cytological features, perineural invasion, and the presence of necrosis. Metastatic spread occurs in up to 80% of high-grade tumors and it is a strong predictor of poor outcome, however, the mechanisms underlying this process are largely unknown. Large-scale microRNA expression profiling studies of human cancers have demonstrated that dysregulation of miRNA is frequently associated with many cancer types. MicroRNAs (miRNAs) are approximately 22 nucleotide non-coding RNA molecules that regulate gene expression posttranscriptionally and are involved in various biological processes. Purpose: The aim of this study was to investigate the microRNA profile in metastatic versus nonmetastatic MECs. Method: Using Real Time RT-PCR we have analyzed the expression of 762 miRNAs and controls using the TaqMan Array Human MicroRNA A+B Cards in FFPE samples from 2 metastatic MEC, 2 non-metastatic MEC and 2 non-neoplastic human salivary gland. Results: The microRNA profile was able to discriminate between normal and tumor samples and between metastatic and non-metastatic tumors. Considering tumor and normal samples, 29 microRNAs were differentially expressed. The metastatic versus non-metastatic analysis demonstrated that 62 microRNAs were differentially expressed. Conclusions: Our results suggest that microRNA profiles could discriminate the metastatic potential of salivary MECs and might be helpful in diagnostic and prognostic evaluation of patients. Financial Support: FAPESP 11/02051-6

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IAOO Abstract Issue OP225. COMPARISON OF ADJUVANT CHEMORADIATION TO ADJUVANT RADIATION THERAPY FOR ADVANCED SALIVARY MALIGNANCIES Phillip Knollman, Jonathan J LU.S.Ardi, Cheryl C Nocon, Elizabeth A Blair 1. Section of Otolaryngology/Head and Neck Surgery, Department of Surgery, University of Chicago Medicine, Chicago, U.S.A. Introduction: Salivary gland malignancies are relatively uncommon in head and neck cancer. While evidence supports the role of post-operative radiotherapy (XRT) in cases with poor prognostic features, the role of adjuvant chemoradiotherapy (CRT) continues to be studied. Purpose: To analyze survival outcomes of patients undergoing surgery followed adjuvant CRT or XRT within a single institution. Methods: We conducted a retrospective review of patients diagnosed at our institution with primary salivary gland malignancy. Cases were obtained from a cancer registry database, and patients treated for only recurrent or metastatic disease were excluded. Clinical data including tumor site, histology, staging, treatment, and clinical outcomes were collected. Kaplan-Meier analysis was used to calculate survival curves for locoregional progression-free, distant metastasis-free, and overall survival. Results: Seventy-four patients from 1980 to 2008 were treated at our institution with surgical resection followed by either adjuvant XRT or CRT for primary salivary gland malignancies. Thirty-seven patients were treated with CRT compared to 37 patients treated with XRT. The locoregional progression-free survival, distance metastasis-free survival, and overall survival were not significantly different between the two groups (CRT vs XRT: locoregional 78.9% vs 100%, p=0.061; metastasis 45.6% vs 62.5%, p=0.106; overall 48% vs 49%, p=0.370). Thirty-five of 37 (94.5%) patients in the CRT cohort had advanced stage disease compared to 13 of 37 (35%) patients in the XRT cohort. Conclusions: In advanced stage or aggressive salivary gland cancer, adjuvant CRT shows similar survival outcomes which compare favorably to patients treated for less advanced cancer with XRT. OP226. CLINICAL STUDY ON TREATMENT OF RECURRENT OR LOCALLY ADVANCED PAROTID GLAND CARCINOMA BY 125I BRACHYTHERAPY ALONE Jie Zhang, Chen Zhou, Lei Zheng, Shuming Liu, Mingwei Huang, Yan Shi, Xiaoming Lu, Jianguo Zhang Department of Oral & Maxillofacial Surgery, Peking University School of Stomatology, Beijing, China Introduction: Recurrent or locally advanced parotid gland cancers pose a great challenge. Radioactive iodine (125I) seed brachytherapy remains an attractive option for irradiating limited areas with high doses of radiation. Purpose: To review the management of recurrent or locally advanced parotid gland carcinoma treated by 125I brachytherapy alone, focusing on prognostic factors of tumor control and survival. Method: 59 patients with parotid gland carcinoma treated by 125I brachytherapy alone between October 2005 and July 2013 was recruited and analysed retrospectively. Results: The average follow-up was 26.7 months( median, 22 months). Among the 23 primary tumors, 6 suffered local failure and 11 suffered death. While for the 36 recurrent cases, the local failing and dead number was 8 and 10 respectively. The 3-year and 5-year local control rate were 76.6% and 59.6%. The 3-year and 5-year overall survival rate were 58.3% and 53.5%. A Cox proportional hazard model identified lymph node metastases and course of disease as independent predictors of local control (P=0.0040,05 under in Fanconi Anaemia patients. The present study showed that the Fanconi Anaemia patients have smaller gland and thus they present a deficient in growth hormone, short stature and necessity of hormone replacement as it is provided during the treatement. PP083. EARLY DETECTION OF PREMALIGNANT LESIONS BY UNDERGRADUATE DENTAL STUDENTS: A PRELIMINARY STUDY Anne-Gaëlle Bodard1-2, Charlotte Heuzé2, Denis Bourgeois2 1. Surgery Department, Centre Léon Bérard, Lyon, France 2. Dental faculty and University Claude Bernard Lyon I, Lyon, France E176

IAOO Abstract Issue Introduction: Oral cancer patients generally present with advances tumors due in part to delayed diagnosis by the general dental practitioner. The aim of the study was to evaluate the screening ability (predictive value) of sixth year dental students and compare their findings with a specialist’s evaluation. Material and method: Patients over 45 years, smokers and/or drinkers were independently examined by a sixth year dental student and by a specialist. A questionnaire evaluated the type and location of the lesion. A comparison between students’ and specialist’s evaluation was made. Results: 30 patients were examined. For 7 patients, both students and specialists diagnosed a keratosis. 5 lesions were not diagnosed by students, and for 10 patients the students’ diagnosis was false or uncertain. For 3 patients, oral lesions were seen by students but no lesions were identified by the specialist. Discussion: The pre-selected population and the fact that students knew they participated to a study render them more attentive to oral lesions, which could explain the good screening and the false positive results for 3 patients. Despite dental students seem aware on oral lesions, lack of accuracy in their diagnosis remain. In many countries, 35 to 42% of general dental practitioners do not feel confident in the diagnosis of oral cancer. This preliminary study shows that there is a need to reinforce the undergraduate dental student training and education in prevention and early detection of oral lesions. PP084. TOBACCO RELATED ORAL CANCER PREVENTION AND EARLY DETECTION DRIVES IN INDIA LED TO SIGNIFICANT REDUCTION IN MORTALITY RATE OVER A DECADE Subhash Desai, Anil D’Cruz, Surendra Shashtri, Rajendra Badwe Tata Memorial Hospital, Mumbai, India Introduction:Oral cancer accounts for about 40% of all new cancers in India. Tobacco chewing is is unique to India and is the main cause of oral cancers. It is very common to see tobacco chewing and smoking in children and in all strata of society. More than 60% present at advanced stage and has resulted in mortality of 25%; a serious cause of concern. Early detection would thus improve cure rates. Purpose:It is our intension to show the various measures adopted by our hospital and the government to help control tobacco addiction and its aftermaths. Various initiatives like the tobacco control act, antitobacco drives and voice of tobacco victims will be show cased in posters along with pictorial educative and awareness materials that are advertised on the social media. Social activists are included to give adequate stress on prevention, early diagnosis, treatment and rehabilitation of these populations. Results:Persistent and vigorous all side-attack programs over a decade, including home and slum visits and, refU.S.Al of government to take or give aid to tobacco-related industries has gone a long way to bring down tobacco related oral cancer mortality from 17 % in 2004 to 9% in 2014. Conclusion: We hope that similar measures would benefit other countries, especially the under developed ones and help reduce the global cancer burden. PP085. PREVENTION AND EARLY DETECTION OF ORAL CANCER IN THE STATE OF PARANÁBRAZIL BETWEEN 2009-2013 Laurindo Moacir Sassi1,2, José Luis Dissenha2, Juliana Lucena Schussel2, Roberta T StramandinoliZanicotti2, Fernando L Zanferrari2, Maria Isabela Guebur2, Daniela Cristina Lunelli2, William Phillip Pereira da Silva2, Larissa Balbo Zavarez2, Joslei Carlos Bohn2, Dayane Salviano Figueiredo2, Gyl H A Ramos3, Paola A G Pedruzzi3, Dinarte Orlandi4 1. Chair, Departament of Oral and Maxillofacial Surgery, Erasto Gaertner Hospital- Oncology HospitalCuritiba-Pr-Brazil 2. Departament of Oral and Maxillofacial Surgery, Erasto Gaertner Hospital- Oncology Hospital-CuritibaPr-Brazil 3. Departament of Head and Neck Surgery, Erasto Gaertner Hospital- Oncology Hospital-Curitiba-Pr-Brazil 4. Registration Department, Erasto Gaertner Hospital- Oncology Hospital-Curitiba-Pr-Brazil Introduction: Campaigns are held for oral assessment and public awareness of the risks associated with oral cancer (OC). E177

IAOO Abstract Issue Purpose: The aim of the study was to report the results of population oral screening between the years of 2009-2013 in the state of Paraná – Brazil. Method: OC prevention campaigns were performed in 116 municipalities and a total of 22,909 patients were examined. 3,930 lesions found by experts of the Erasto Gaertner Hospital (Curitiba-PR). Demographic data was collected. Clinical examination evaluated the presence of dentures, oral hygiene and presence of oral lesions. Finally, all patients received information on OC prevention. Results: Most individuals were female (62.5%) and leukoderma (82.2%). Among them, 61.2% received less than two minimum wages. Regarding education, 58.9% had not finished elementary school, 19.2% finished high school and 8.3% had higher education, 10.7% illiterate. Most individuals only visit the dentist when in pain (27.4%) and 29.7% reported one or two times a year consultation; 18.3% were edentulous. Among risk factors, alcohol consumption (15.9%) and smoking (21.6%); consumption of hot tea 36.9%. Oral hygiene was considered regular in 51.6% and bad in 26.8%. Six percent of patients never heard of OC prevention, and 80.5% never done oral exam for prevention. Patients who presented oral lesion were referred to Hospital: 30.7% inflammatory, 44.3% traumatic, 8.4% leukoplakia, 7.6% papilloma, 8.3% with characteristic for malignancy. Conclusion: The highest number of lesions 766 (67.7%) was found in people between 41-70 years old. New health actions must be made to improve prevention. PP086. NON-SMOKING AND NON-DRINKING VS SMOKING AND DRINKING PATIENTS WITH LIP SQUAMOUS CELL CARCINOMA IN A BRAZILIAN ORAL CANCER CENTER: CLINICOPATHOLOGICAL CHARACTERISTICS Vitor Bonetti Valente1, Bruna Mantovan2, Ana Raphaela Curvo3, Maria Lúcia Marçal Mazza Sundefeld3, Éder Ricardo Biasoli3, Glauco Issamu Miyahara3, Daniel Galera Bernabé3 1. Stomatology, Oral Oncology Center, Department of Pathology and Clinical Propedeutics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil 2. Dental Surgeon, Oral Oncology Center, Department of Pathology and Clinical Propedeutics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil 3. Oral Oncology Center, Department of Pathology and Clinical Propedeutics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, Araçatuba, São Paulo, Brazil Introduction: Studies have showed that non-smoking and non-drinking (NSND) patients with oral squamous cell carcinoma display a different clinical profile compared to smoking and drinking (SD) patients. However, there are no specific studies focusing on NSND lip squamous cell carcinoma (LSCC) patients. Purpose: To compare clinicopathological characteristics of non-smoking and non-drinking (NSND) vs smoking and drinking (SD) lip squamous cell carcinoma (LSCC) patients. Method: Retrospective data analysis from 144 LSCC patients treated in the Oral Oncology Center Araçatuba Dental School, São Paulo State University - UNESP, São Paulo, Brazil. Results: Third-eight LSCC patients (26.3%) had no history of smoking and drinking intake, then they were considered NSND. The mean age for NSND was 64.08 years vs 58.81 years for SD. NSND-LSCC patients were typically male (n=30; 78.9% vs 82.1% of SD) and white (n=37; 97.37% vs 91.51% of SD). The most LSCC patients (91.3%) presented initial clinical stage (I and II), and there was no differences in clinical stage between NSND and SD patients, such as advanced stages (p>0.05). The NSND and SD groups did not show differences in comorbidities and family cancer history. The recurrence and second primary tumor (SPT) rates were 4.9% and 5.6%, respectively, for all patients. There were no differences between NSND and SD groups in incidence of recurrence and SPT (p>0.05). Specific and global survival rates were not statistically significant for both groups (p>0.05). Conclusions: Our study shows that NSND and SD patients had similar clinicopathological characteristics for LSCC.

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IAOO Abstract Issue PP087. EPIDEMIOLOGICAL SURVEY OF ORAL LESIONS IN CHILDREN Aline Picetti, Maria Noel Petruzzi, Karen Cherubini, Fernanda Salum, Maria Antonia Figueiredo Postgraduate Program Dental College, Pontifical Catholic University of Rio Grande do Sul – PUCRS, Porto Alegre, RS, Brazil Introduction: Few surveys evaluated the prevalence of oral diseases in children, perpetuating the existent controversial on the exact prevalence and spectrum of stomatological affection in pediatric patients Purpose: To assess the spectrum and prevalence of oral lesions in children from a Southern Brazilian sample. Methods: A retrospective cross-sectional survey was conducted using 1,217 dental records of individuals that attended for stomatological consultation between March 1977 and March 2012. Case records were reviewed for the presence of oral affections and relevant clinical data were collected systematically. Clinical diagnostic criteria proposed by the World Health Organization were considered. Descriptive statistics were performed. Results: Frequency of oral lesions was 93.9%, 52% of the sample were female and 32% were aged between 10 and 12 years. The main complaint was swelling (40.9%) and 22% of patients’ presented symptomatic conditions. Nearly 60% of clinical findings affected exclusively the oral mucosa and 5.5% of lesions developed in the jaws. Most prevalent alterations were of inflammatory origin (31.2%) followed by salivary glands affections (17.3%) and viral infections (8.8%). Malignant tumors were of rare occurrence (0.3%). In children aged 4-12 years the most prevalent lesion was mucocele (14.1%). Geographic tongue was the alteration predominantly seen in children with 1-3 years of age (22.5%) and among those up to 1-year old (12.5%). Conclusion: The high prevalence and broad range of lesions detected in this sample should encourage practitioners to perform a carefully clinical investigation of oral tissues in children in order to provide early diagnosis and proper care. PP088. EPIDEMIOLOGICAL PROFILE OF ORAL MALIGNANT NEOPLASMS IN 5 YEARS AT A BRAZILIAN CANCER INSTITUTE Lucas Allan Ribeiro Porfírio1, Thais Feres Moreira Lima2, Larissa Karolynne Ribeiro Porfírio4, Ludmila Nathaly Ribeiro Porfírio3, Sebastião Porfírio da Silva3, Raimunda Ribeiro da Silva3 1. Federal University of Rio de Janeiro, Rio de Janeiro, Brazil. 2. Federal University Of Maranhao, Maranhao, Brazil 3. Institute Of Oncology Aldenora Bello-Imoab, Brazil 4. Estacio De Sa University, Brazil Introduction: There is a wide variation in the incidence and mortality rates of Oral Cancer in different regions around the world. Except for lip cancer, which is associated to excessive sun exposure, Oral Cancer is related to age greater than 40 years, smoking pipes and cigarettes, alcohol consumption, poor oral hygiene, family history of cancer and improperly fitted dentures. Purpose: Determine the most likely sites of oral cancer and correlate with different risk factors. Method: Analysis of 181 cases of oral cancer at the Institute of Cancer Aldenora Bello-IMOAB between 2007-2011, setting the site and histological types, risk factors, gender and occupation. The diagnosis was obtained through histopathology. Results: The incidence of the various cancer types was as follows: 6,6% lips; 22,1% base of the tongue; 29,3% other parts of the tongue; 1,7% gum; 15,5% mouth floor; 13,8% palate and 11,0% other parts of the mouth. The average age was 64 years old, including only 8 cases in patients below 40 years old. 53 of the 181 patients are farmers. Most of the patients are men and smokers/alcohol drinkers. Conclusions: Oral cancer is amongst the tenth most common tumor in Brazil and worldwide. More than 50% of the cases are located in the tongue. Almost one third of the patients are farmers, which proves that the sun exposure is still a major risk factor. Smoking and drinking lead to oral cancer, however the number of women patients is increasing, probably due to the change of these social habits on females. E179

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PP089. BETA-BLOCKER USE AND THE SURVIVAL OF PATIENTS WITH HEAD AND NECK CANCER Alen Chen, Madathil Sreenath, Letian Li, Makhoul Nicholas, Tamimi Faleh, Nicolau Belinda Faculty of Dentistry, McGill University, Montreal, Quebec, Canada Background: β-blockers are drugs commonly prescribed for the management of cardiac arrhythmias and hypertension. They reduce stress on the heart by blocking the action of the sympathetic nervous system of the heart. β-blockers seem to have an anti-proliferation effect in tumors and increase survival of cancer patients. However, specific studies on head and neck cancer (H&NC) have not been carried out. We evaluate whether exposure to β-blockers is associated with decreased mortality and tumor progression in H&NC patients. Method: We are conducting a retrospective chart review of H&NC patients attending the Notre-Dame Hospital, Montreal, Canada Information collected includes socio-demographic, date of hospital admissions, diagnostic tests, cancer stage, progression, treatment, medical history, smoking and alcohol habits, body weight history, treatment side-effects, follow-up and survival. Preliminary data analysis include descriptive statistics. Results: As of January 2015, we have collected information on 147 patients. Among these subjects, the majority is male 113 (77%) and had cancer in the oral cavity (44%). In total, 15 patients (10%) are using beta-blockers. Regarding treatment, 48 (33%) patients had only radiotherapy, 48 (33%) had chemotherapy and radiotherapy, 17 (12%) had surgery and radiotherapy while 11 (7%) had all three treatment. Ten percent of cancer patients have had a recurrence of their cancer. Interestingly, none of the patient taking beta-blockers had a recurrence. Conclusions: Although the data collection has not been finalized, we believe that this cohort study has pertinent clinical relevance. Beta-blockers may become a cost-effective drug which reduces cancer mortality in conjunction with traditional cancer treatment PP090. SQUAMOUS CELL CARCINOMA OF THE LIP SURVIVAL RATE IN A PUBLIC CHILEAN INSTITUTION Araya S. Cristobal1,2, Sazo B. Nicolás1,Cabello B. Tania1, Martínez R. Benjamín1,2, Salgado F. Apolo3. 1. Facultad de Odontología, Universidad Mayor, Santiago de Chile. 2. Patología General y Oral, Facultad de Odontología, Universidad mayor, Santiago de Chile. 3. Médico Radioterapeuta, Instituto Nacional del Cáncer, Santiago de Chile. Introduction: The Squamous Cell Carcinoma (SCC) of the lip represents about 20% of all oral carcinomas with oral commitment. UV radiation is one of the most common risk factor associated to developing this disease. Lower lip is most affected than upper, affecting mostly men between the sixth and seventh decade of life. Purpose: Determine the percentage of survival at 5 years for patients diagnosed with SCC of lip in the National Cancer Institute Chile. Method: Records and books of medical committee were reviewed to confirm histopathological diagnosis of SCC per patient. Other locations and histopathological variants were excluded. 74 patients were tabulated and determine who had died from death certificate. Kaplan Meier (KM) and the log rank test was conducted to establish the survival (statistical significance p 0.05). In AC group, one (3:33%) did not express RASSF1-1A, one (3:33%) showed positivity only in basal layer and 28 (93.34%) showed overexpression in the basal and suprabasal layers, except in keratin layer. In SCC, this protein was underexpressed in 7 (20:59%) and overexpressed in 27 (79.41%) cases. Conclusions: Hypermethylation of the two RASSF-1A segments studied was observed in approximately 50% of SCC cases, but was not correlated to clinical-pathological parameters. PP123. MICRORNAS MARKERS FOR THE PRESENCE OF LYMPH NODES METASTASIS IN PATIENTS WITH ORAL SQUAMOUS CELL CARCINOMAS Fernando Tadeu Zamunér1, André Lopes Carvalho2, Luiz Paulo Kowalski3, André L. Vettore1. 1. Biochemistry Department, Federal University of São Paulo, Unifesp, São Paulo, Brazil 2. Head and Neck Surgery Department, Barretos Cancer Hospital, Barretos, São Paulo, Brazil 3. Head and Neck Surgery Department, A.C.Camargo Cancer Center, São Paulo, Brazil Introduction: Oral cancer is the most common subset of head and neck squamous cell carcinomas (OSCC). These tumors often have an aggressive clinical outcome hallmarked by a propensity for local invasion and regional nodal metastasis. The presence of metastatic disease in cervical lymph nodes is an important prognostic factor and it influences in the choice of the therapeutic strategy to be adopted. E197

IAOO Abstract Issue Thus, the identification of molecular markers able to select patients who are at high risk for lymph node metastasis and/or locoregional recurrence could be of great value. Recent studies have shown that microRNAs can be regulators of the tumor metastasis process by the activation of various signaling pathways involved in this process being useful in diagnosis, determination of disease prognosis and prediction of therapeutic response. Purpose: to identify microRNAs expressed in OSCC associated with the presence of lymph node metastasis. Methods: Tumor samples were obtained from patients diagnosed with OSCC at the Head and Neck Surgery Department, Cancer Hospital of Barretos. For microRNA microarrays experiments, total RNA from 32 tumor samples (12 without lymph node metastasis and 12 with metastasis) was extracted labelled and hybridizated Analysis of microarray data was performed using GeneSpring GX 12.0 and R program. Results: This analysis allowed the identification of 10 microRNAs differentially expressed in the comparison between metastatic and non-metastatic OCCS cases. Conclusions: these microRNAs will be validate and selected by qRTPCR in an independent cohort of OSCC patients and correlate the molecular data with the clinical features of the patients. PP124. DETECTION OF HPV IN FOUR HUMAN TISSUES EXTRACTED FROM PATIENTS WITH AND WITHOUT LEUKOPLAKIA Lígia Ferreira1, Éder Biasoli1, Daniel Bernabé1, Cáris Nunes2,Luis Veronesi3,Glauco Miyahara1. 1. Oral Oncology Center, Araçatuba Dental School, Universidade Estadual Paulista, Araçatuba, São Paulo, Brazil. 2. Department of Animal Health and Production, São Paulo State University-UNESP, Campus Araçatuba, São Paulo, Brazil. 3. Veronese Pathology and Cytology - Araçatuba - São Paulo – Brasil Introduction: Oral leukoplakia is considered a potentially malignant lesion for the development of squamous cell carcinoma, and various risk factors may be related to this carcinogenesis, including the human papillomavirus (HPV). Purpose: The aim of this case-control study was to detect the presence of HPV in fresh tissue, plasma and saliva samples obtained from patients with and without oral leukoplakia, and verify the correlation in the presence of viral DNA between different sources of human tissues. Method: Thirty-two patients with oral leukoplakia and 24 control patients were included. DNA extraction from the samples was performed, and afterwards it was amplified by nPCR for the detection of HPV. Results: The DNA of HPV was found in 68.75% and 45.8% (p=0.334) of the fresh tissue samples, 50% and 54% (p=0.723) in plasma and 62.5% and 45.8% (p=0,925) in saliva in the patients with leukoplakia and control group respectively. Interesting, positive samples in plasma presented correlation with the positive samples in fresh tissue (p=0.006). Conclusions: Based on the present study, there was no difference in the rate of detection of HPV in patients with or without oral leukoplakia. Moreover, the results suggest that plasma may be an important source of HPV detection in leukoplakia patients PP125. VALIDATION OF METHYLATION MARKERS FOR DIAGNOSIS OF ORAL CAVITY CANCER Lidia MRB Arantes1,2, Ana Carolina de Carvalho1, Matias E Melendez1, Cristiane C Centrone3, Eloiza H Tajara2, Eny Maria Goloni-Bertollo2, André L Carvalho1, GENCAPO4 1. Molecular Oncology Research Center, Barretos Cancer Hospital – Pio XII, Barretos – SP, Brazil. 2. Departmentof Molecular Biology, São José do Rio Preto Medical School (FAMERP), São José do Rio Preto – SP, Brazil. 3. Virology Laboratory, Institute of Tropical Medicine of São Paulo, University of São Paulo, São Paulo – SP, Brazil. 4. GENCAPO - Head and Neck Genome Project. E198

IAOO Abstract Issue Inroduction: The increase in methylation at the promoter region of a tumor suppressor gene can lead to gene inactivation, selecting cells with proliferative advantage. Thus, promoter hypermethylation is considered a marker in a variety of malignant tumors, including oral cavity. Purpose: To evaluate the methylation pattern of AIM1, CCNA1, CDH1, DAPK, DCC, HIC1, MGMT and TIMP3. Methods: Forty oral cavity squamous cell carcinomas (OSCC) and 40 saliva samples from healthy individuals were evaluated by Q-MSP. Different combinations of genes were also assessed in order to identify gene panels that could better distinguish between OSCC and saliva samples. Results: CCNA1, DAPK, DCC and TIMP3 methylation were highly specific for being found in the OSCC samples. Moreover, the combination of these genes improved detection when compared with single markers, reaching values of 92.5% for sensitivity and specificity (when using the panel CCNA1, DCC, TIMP3). Moreover, DAPK, DCC and TIMP3 were hypermethylated in nearly 90% of clinically T1 and T2 cases. Conclusion: We were able to validate a panel for OSCC detection with high specificity and high sensitivity (CCNA1, DCC, TIMP3). The identification of these markers in early stages of OSCC shows the feasibility of using the panel on saliva as possible biomarkers for early diagnosis. The lack of association between the methylation status of these genes and clinical characteristics is indicative that they are able to distinguish OSCC cases irrespective of social and clinical factors. PP126. INTEGRATIVE TRANSCRIPTOMIC AND miRNA ANALYSES REVEAL PUTATIVE BIOMARKERS IN LEUKOPLASIAS André Guollo1, Vanessa Almeida Simões1, Hellen Kuasne1, Julia Mariko1, Fabio Marchi1, Mateus C. BarrosFilho1, Ana Paula Molina Vivas1, Fabio Abreu Alves1, Katia Muller2, Belinda Nicolau2, Nicolas F Schlecht3, Luiz Paulo Kowaslki1, Silvia R Rogatto 1,4 1. AC Camargo Cancer Center, SP, Brazil 2. Faculty of Dentistry, McGill, University, Montreal, Canada 3. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, U.S.A 4. Department of Urology, Faculty of Medicine, UNESP, Botucatu, SP, Brazil Introduction: Leukoplakia (OL) is the most frequent potentially malignant disorder of the oral mucosa. OL show different rates of malignant transformation ranging from 11% to 13% of cases. The etiological factors frequently described as associated with OL are tobacco U.S.Age and alcohol consumption. To date there are few studies describing molecular alterations in OL. Integrative analyses of coding and noncoding (miRNAs) transcripts have the potential to identify predictive markers for cancerization. Purpose: The aim of this study was to evaluate the molecular profile of OL using miRNA and mRNA expression data. Method: Sixteen patients were prospectively enrolled for collection of OL and normal contralateral (NC) samples (average follow-up of 34 months). Gene expression profile was evaluated using the Whole Human Genome 4x44K platform (Agilent Technologies) and the Human miRNA Microarray 8x60K (Agilent Technologies) platform for global miRNA expression analysis. In silico miRNA target prediction was performed using TargetScan. Integrative analysis between miRNA expression and coding transcripts was carried out (Pearson correlation). RT-qPCR was used to confirm the results in an independent validation group (NC=7, OL=54). Results: The analysis showed that seven downexpressed miRNAs potentially regulate 34 overexpressed mRNAs. Downexpression of hsa-miR-191 (p=0.0002), hsa-miR-1228 (p=0.002) and hsa-miR-4313 (p=0.0052) were further confirmed by RT-qPCR. A combination of these three miRNAs clearly separated OL from NC samples (98% accuracy). Conclusions: Potential biomarkers were identified in OL implying that the deregulation of hsa-miR-191, hsa-miR-1228 and hsa-miR-4313 are discrimination factors between OL from NC.

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IAOO Abstract Issue PP127. EXPRESSION OF EPIDERMAL GROWTH FACTOR RECEPTOR (EGFR) AND MULTIDRUG RESISTANCE-ASSOCIATED PROTEIN 2 (MRP-2) IN CIRCULATING TUMOR CELLS (CTCs) OF LOCALLY ADVANCED HEAD AND NECK SQUAMOUS CELL CARCINOMA (LAHNSCC) USING THE ISOLATION BY SIZE (ISET) METHOD: PRELIMINARY RESULTS OF A PROSPECTIVE STUDY Thiago Bueno de Oliveira, Ulisses Ribaldo Nicolau, Daniel Garcia, Victor Hugo Fonseca de Jesus, Vanessa Alves Silva, Juliana Valim Romero, Marcieli Eliza Buim, Luis Paulo Kowalski, Marcello Ferretti Fanelli, Ludmilla Thome Domingos Chinen AC. Camargo Cancer Center São Paulo, Brazil Introduction: Currently there are different options of treatment for LAHNSCC patients: upfront surgery followed by radiotherapy (RT), RT with chemotherapy (CT) or cetuximab preceded or not by induction CT (ICT). Despite efforts, there are no predictive biomarkers to guide the choice of therapy. Purpose: The aim of this study is to determine the prognostic role of CTCs in LAHNSCC patients treated with a curative intent and to correlate its counts and biomarkers expression with response to treatment. Methods: Blood samples of 30 non-metastatic LAHNSCC patients, stages III/ IV, were analyzed for CTCs using the ISET method, in two scenarios: curative surgical resection and adjuvant treatment (RT +/- CT) and candidates for a non-surgical strategy (unresectable or organ- preservation) based on combination of RT with CT or cetuximab, with or without ICT. The analysis included CTCs counts and expression of predictive biomarkers. Results:The median number of baseline CTCs was 3.0/ml (0-11). Patients with ≥3 CTCs/ml had significant higher expression of MRP-2 (p=0,012) but not EGFR (p=0,115). To this point, no association was found between CTCs counts, biomarker expression and survival or response. Conclusions: Patients with LAHNSCC and higher counts of baseline CTCs had higher expression of MRP2. Circulating tumor cells can have a role in guiding therapy of LAHNSCC. PP128. EXOSOMAL MICRORNA21 EXPRESSION IN CD44- AND CD133-POSITIVE ORAL CANCER STEM CELL SUBPOPULATIONS. Karl Kingsley University of Nevada, Las Vegas – School of Dental Medicine, Department of Biomedical Sciences, Las Vegas, Nevada, U.S.A Introduction: Recent studies have demonstrated many oral tumors contain small subpopulations of cancer stem cells (CSC), which are capable of initiating tumorigenesis and are also resistant to traditional chemotherapy or radiation treatments. Previous work from this group has established oral cancer cell lines CAL27 and SCC25 contain sub-populations of rapidly proliferating, adhesion-independent CD44- and CDD133-positive cancer stem cells that were not present in other cell lines, including SCC15. Purpose: As more evidence accumulates describing the role of micro-RNA (miRNA) miR-34 modulation of specific cancer stem cell markers, the purpose of this study was to explore expression of additional oral cancer microRNAs and CSC subpopulations within cell lines. Method: Molecular screening of RNA extracted from the cellular and supernatant (exosome) fractions of SCC4, SCC9, SCC15, SCC25 and CAL27 cancer cell lines and CSC subpopulations from SCC25 and CAL27, was performed using primers specific miR-16, miR-21, miR-133 and miR-155 for comparison with cellular phenotypes and other CSC-specific biomarkers. Results: miR-21 in the exosome fraction was restricted to the most rapidly proliferating cell lines, with CSC subpopulations expressing surface biomarkers CD44, CD133 and CD24 and intracellular biomarkers NANOG, Oct4 and Sox2 - with differential expression of miR-133 and miR-155. miR-16 detection in supernatant was restricted to normal, non-cancerous controls. Conclusions: Elucidating mechanisms and processes responsible for CSC survival and growth remains a central focus of oral cancer researchers. This study may be among the first to provide new evidence of differential and specific miR-21 exosome expression within CSC subpopulations.

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IAOO Abstract Issue PP129. NEXT-GENERATION SEQUENCING OF TP53 IN ORAL SQUAMOUS CELL CARCINOMA: PROGNOSTIC IMPLICATIONS Ana Flávia Costa 1,2, Frederico Gleber-Netto 1, Natalie Kelner 2, Diana Noronha Nunes 1, Luiz Paulo Kowalski2, Emmanuel Dias-Neto 1 1. Laboratory of Medical Genomics, AC Camargo Cancer Center, São Paulo, SP, Brazil; 2. Department of Head and Neck and Otorhinolaryngology Surgery, AC Camargo Cancer Center, São Paulo, Brazil. Introduction: There are no currently available biomarkers to guide therapeutic decisions in head and neck squamous cell carcinoma (HNSCC). Here we investigated whether TP53 mutations , revealed by Next-Generation-Sequencing (NGS) would have prognostic implications. Purpose: We investigated the prognostic impact of TP53 mutations in HNSCC, including their number, location and frequency of mutated reads in HNSCC. Methods: Mutations were investigated in DNA derived from 65 primary HNSCC tumor samples using Ion Torrent Ampliseq TP53-panel. Particular attention was given to aspects that could be revealed by the large coverage given by NGS: the number of reads carrying mutations as well as the number of TP53 mutations for each patient. Results: After generating 8.5 million reads, with an average coverage of above 1000X/patient, we observed TP53 mutations in 63% of cases. Worse outcome was observed in patients carrying nonsense and frameshift-mutations, especially when located in the DNA binding-domain. Bad-prognosis effect was also seen for patients carrying >1 mutation and for those with a frequency of mutant reads >50%, regardless of the mutation type. Conclusions: The well-known worse prognostic effect of truncating mutations was confirmed but we have also identified an important bad effect given by mutations are present in the majority of the tumor cells, reinforcing the driver effect of TP53 genes and relevance of tumor heterogeneity: tumors with a mutation frequency >50% had worse prognosis

 

PP130. EXPRESSION PROFILE OF XENOBIOTIC METABOLISM PATHWAY GENES IN ORAL CAVITY CANCER Anelise Russo1, Patrícia Matos Biselli-Chicote1, Márcia Maria Urbanin Castanhole-Nunes, André Rodrigueiro Clavisio Pereira de Oliveira, Cláudia Regina dos Santos Silva, Ana Paula D’Alarme Gimenez-Martins, Tairine Zara Lopes, José Victor Maniglia2, Dalisio de Santi Neto2, Érika Cristina Pavarino1, Eny Maria Goloni Bertollo1 1. Research Unit in Genetics and Molecular Biology – UPGEM / São José do Rio Preto Medical School (FAMERP) 2. Department of Otorhinolaryngology and Head and Neck Surgery - FAMERP São José do Rio Preto, SP, Brazil Introduction: Susceptibility to enviromental agents and its adverse effects health depends of the profile personal genetic. Most estimates of neoplasias results of the interaction between genetic and environmental factors as smoking and drinking. Expression modification of the xenobiotic metabolizing genes, such as cytochrome P450 (CYP) family members, can be associated with head and neck carcinogenesis. Purpose: This study aims to identify gene expression profile in patients with oral cavity cancer, in order to assess susceptibility biomarkers of this cancer type, using eight patient tissue samples with pathological diagnosis of oral cavity squamous cell carcinoma and eight adjacent non tumoral tissue samples. Method: Evaluation of gene expression was performed by RT-qPCR (Real Time – quantitative Polymerase Chain Reaction) with TaqMan® Array Human CYP450 and other Oxygenases, Fast 96-well Plate (Applied Biosystems) in duplicate reactions. Molecular findings were statistically evaluated by GraphPad Prism v6. Results: Findings showed that genes (median): CYP20A1 (1,01), CYB5R3 (1,42), CYB5R1 (1,71), CYB5B (2,15), CYB5R2 (2,38), CYB5R4 (2,61), ALOXE3 (3,74), CYP27C1 (4,63), CYP27B1 (6,28), CYP24A1 (9,39) were high expressed; while genes: ALOX12 (0,028), CYP2C19 (0,09), CYP2C9 (0,087), CYP27A1 E201

IAOO Abstract Issue (0,36), ALOX5 (0,46), CYP2A6 (0,63), CYP26B1 (0,75), CYP1B1 (0,94) were found low expression, although it was not statistically significant due to be partial results of major study. Conclusion: Further studies are still necessary for a better understanding of this association. Results may contribute to the understanding the etiopathogenesis-related gene expression in the pathway of metabolism of xenobiotics in oral cavity carcinogenesis. Financial Support: FAPESP nº 2013/04923-6, CNPq and CAPES; support: FAMERP/FUNFARME. PP131. INVESTIGATION OF GLYPICANS 1, 3 AND 5 TRANSCRIPTS AND PROTEINS IN ORAL SQUAMOUS CELL CARCINOMA Rebeca Carolina Moraes Dantas, Caroline Brandi Schlaepfer Sales, Rosane Borges Dias, Ludmila de Faro Valverde, Vanessa SoU.S.A Nazaré Guimarães, Deise Souza Villas Bôas, Jean Nunes dos Santos, Clarissa Araújo Gurgel Rocha Laboratory of Pathology and Molecular Biology, Oswaldo Cruz Foundation, Bahia, Brazil Introduction: Glypicans (GPCs) play a role in the regulation of cell proliferation and survival, particularly during malignant transformation. Purpose: Evaluate the expression of GPC1, 3 and 5 genes and proteins in Oral Squamous Cell Carcinoma (OSCC). Method: A total of 31 cases of OSCC were assessed by qPCR for GPC1, GPC3 and GPC5 genes, performed in VIIA™ 7 Real-Time PCR System using the Taqman enzime. Immunohistochemical for GPC1, GPC3 and GPC5 proteins was performed on 26 OSCC, 9 cases of tumor margins (TM) and 4 cases of nonneoplastic oral mucosa (NNM) using AdvanceTM system. The analysis was conducted according to the semi-quantitative parameters described by Gurgel et al. (2008). Results: Transcripts of GPC1 (26; 83.87%), GPC3 (n=22; 70.97%) and GPC5 (n=15; 48.38%) genes were observed in OSCC. Cytoplasmic and membrane immunostaining of GPC1 was mainly observed in epithelial MNN (n = 5; 100%) and MAT (n=9; 100%), while a reduction of this protein was detected in parenchymal cells. GPC3 protein were absent in MNN and MAT. The GPC3 occurred in the membrane and cytoplasm of parenchymal cells, mainly observed in the periphery of the tumor islands and the 3+ score was predominant (n=3; 11:56%). GPC5 positive tumor cells occurred in the cytoplasm, scored 1+ (n = 5; 38.46%). In addition, GPC5 was detected in the stroma of 13 (50%) OSCC, in endothelial and fibroblast cells. Conclusions: In OSCC, gene and protein expression of GPC3 indicate that this protein participates as a tumor suppressor, while GPC5 and GPC3 function as oncoproteins. PP132. METABOLIC PROFILE OF ORAL SQUAMOUS CELL CARCINOMA (OSCC)-ASSOCIATED FIBROBLASTS Renata Goto1, Ludmila Bertanha1, Lays Sobral1, Ricardo Iwakura2, Daniela Palioto3, Luiz C C de Freitas2, Carlos Curti1, Andréia Leopoldino1 1. School of Pharmaceutical Sciences of Ribeirão Preto, São Paulo University, Brazil   2. Head and Neck Surgery Unit of Ribeirao Preto Medical School, São Paulo University, Brazil   3. School of Dentistry of Ribeirão Preto, São Paulo University, Brazil   Introduction: Reprogramming in metabolism is a hallmark of cancer cells. Recently, it was proposed alterations in the metabolism of cancer-associated fibroblasts (CAFs) in addition to the well-known process of fibroblasts differentiation into myofibroblasts. Purpose: To compare the metabolism profile of fibroblasts obtained from oral normal mucosa vs oral squamous cell carcinoma (OSCC)-associated fibroblasts. Methods: Primary cultures of fibroblasts were established from two OSCC tissues (CAF-1 and CAF-2) and one oral healthy mucosa (OHMF-1). All surgically resected OSCC tissues were obtained in the HC-USP of Ribeirão Preto, and oral healthy mucosa tissue in the School of Dentistry of Ribeirão Preto-USP. Fibroblasts were characterized by the presence of vimentin, CD34, pan-cytokeratin (IHC), and α-SMA (immunoblotting). Metabolism profile was defined through glucose uptake, lactate secretion, ATP levels, E202

IAOO Abstract Issue and GLUT-1. Mitochondrial membrane potential (MMP) was assessed with the probe JC-1, and reactive oxygen species (ROS) with H2DCFDA. Results: Only CAF-1 was positive for α-SMA, myofibroblast marker. Interestingly, CAF-1 was established from a patient with invasive lip squamous cell carcinoma (T3N2Mx), while CAF-2 was derived of tissue from a patient with gingival SCC (T2N0Mx). As expected, CAF-1 and CAF-2 showed higher glucose uptake and GLUT-1 compared to OHMF-1. In addition, lactate level was higher in OHMF-1 and CAF-2 compared to CAF-1, which in turn presented the highest level of ATP and the lower ROS level and MMP dissipation. Conclusion: CAFs go towards a metabolic reprogramming, consistently with the “reverse Warburg effect”, and myofibroblast is associated with a behavior more advanced and dissimilar metabolism in OSCC. PP133. GENOMIC FEATURES ASSOCIATED WITH MALIGNANT TRANSFORMATION AND PROGRESSION OF CARCINOMA EX PLEOMORPHIC ADENOMA Fernanda Viviane Mariano1, Rogério de Oliveira Gondak2, Felipe Fidalgo3, Antonio Santos Martins4, Ricardo Della Coletta5, Oslei Paes De Almeida5, Luiz Paulo Kowalski6, Ana Cristina Victorino Krepischi7, Albina Altemani1 1. Pathology Department, Faculty of Medicine -UNICAMP, Campinas-SP, Brazil 2. Pathology Department, Faculty of Santa Catarina (UFSC), Florianópolis-SC, Brazil 3. International Research Center, AC Camargo Cancer Center, São Paulo-SP, Brazil. 4. Head and Neck Surgery Department, Faculty of Medicine - UNICAMP, Campinas-SP, Brazil 5. Oral Pathology Department, Piracicaba Dental School - UNICAMP, Piracicaba-SP, Brazil 6. Head and Neck Surgery Department, AC Camargo Cancer Center, São Paulo-SP, Brazil 7. Department of Genetics and Evolutionary Biology, Institute of Biosciences, USP, São Paulo-SP, Brazil Introduction: Several genetic alterations have been identified individually in carcinoma ex-pleomorphic adenoma (CXPA) and pleomorphic adenoma (PA). Purpose: The aim of this study was to investigate the somatic copy number alterations and involved genes possibly associated with malignant transformation of PA and the different stages of the CXPA progression. Method: Twenty six cases of CXPA and thirteen cases of PA were evaluated by array-CGH using a 180K platform. Results: The CXPA cases were classified as early (8) and frankly invasive (18). The most relevant chromosomal alterations in each group were: chromosome 8 (PA), chromosome 8 and 12 (early invasive) and 1, 5, 6, 8 and 12 (frankly invasive). The amplified genes found in each group were: MAML2 and LIFR (PA), KDM5A, MLLT6, LASP1, CDK12, ERBB2 (early invasive) and MAML2, BIRC3, CDK4, LRIG3, WIF1, HMGA2, MDM2, CDK12, ERBB2, LYL1, EGFR, WHSC1L1, FGFR1 (frankly invasive). Conclusions: Tumor progression of CXPA seems to be associated with an increase of somatic copy number alterations during carcinogenesis. Alterations involving chromosome 8 seems to be important from PA tumorigenesis to frankly invasive carcinoma, whereas copy number alterations involving chromosome 12 appear to be acquired in early invasive carcinoma and maintained in frankly invasive carcinoma. Copy number alterations of chromosomes 1, 5 and 6 would be added in the late stage of the carcinogenesis. KDM5A, MLLT6, LASP1, CDK12, ERBB2 genes may be associated with malignant transformation while BIRC3, CDK4, LRIG3, WIF1, HMGA2, MDM2, LYL1, EGFR, WHSC1L1, FGFR1 would be related to malignant progression (FAPESP: 2011/23204-5, 2011/23366-5). PP134. COMPARATIVE ANALYSIS BETWEEN GENOMIC PROFILE OF RECURRENT PLEOMORPHIC ADENOMA AND PLEOMORPHIC ADENOMA Fernanda Viviane Mariano1, Rogério de Oliveira Gondak2, Erika Egal1, Felipe Fidalgo3, Álfio José Tincani4, Ricardo Della Coletta5, Oslei Paes de Almeida5, Luiz Paulo Kowalski6, Ana Cristina Victorino Krepischi7, Albina Altemani1. 1. Pathology Department, Faculty of Medicine -UNICAMP, Campinas-SP, Brazil E203

IAOO Abstract Issue 2. Pathology Department, Faculty of Santa Catarina (UFSC), Florianópolis-SC, Brazil 3. International Research Center, AC Camargo Cancer Center, São Paulo-SP, Brazil. 4. Head and Neck Surgery Department, Faculty of Medicine - UNICAMP, Campinas-SP, Brazil 5. Oral Pathology Department, Piracicaba Dental School - UNICAMP, Piracicaba-SP, Brazil 6. Head and Neck Surgery Department, AC Camargo Cancer Center, São Paulo-SP, Brazil 7. Department of Genetics and Evolutionary Biology, Institute of Biosciences, USP, São Paulo-SP, Brazil Introduction: The majority of pleomorphic adenoma (PA) shows karyotype abnormalities, of which rearrangements involving 8q12-15 are the most common. The recurrence of tumor can be caused either by increase in the complexity of genetic abnormalities or by acquisition of promoting mutations. Purpose: As in recurrent pleomorphic adenoma (RPA) genetic alterations has yet to be investigated, the aim of this study was to assess by array comparative genomic hybridization (aCGH) the genomic profile of copy number alterations associated with RPA and PA. Method: Four cases of RPA and thirteen cases of PA were evaluated by array-CGH using a 180K platform. Data was analyzed using Nexus Copy Number Discovery. Results: The RPA group showed no copy number alteration, except for one case that exhibited losses in 5p15.33p15.1, 5q13.1q35.3 and 12q12q13.11. PA group also showed few copy number alterations, and the most frequent findings involved the chromosome 8: 8p21.3p12 (gain), 8q12.1 (loss), 8p23.3q24.3 (gain), and 8q12.1q21.11 (gain). Genomic amplifications were revealed in the PA group, and relevant affected genes were MAML2 and LIFR. Conclusion: PAs and RPAs exhibited different patterns of genomic profile. This result suggests that despite the common origin theses tumors, the trigger can be by different mechanisms of tumorigenesis. Copy number alterations at chromosome 8 and the amplification of MAML2 and LIFR genes can be a contributory factor in PA tumorigenesis. However, these genetic alterations might not to play role in the tumor recurrence (FAPESP: 2011/23204-5, 2011/23366-5). PP135. DISTRIBUTION AND SIGNIFICANCE OF INTERSTITIAL FIBROSIS AND STROMAINFILTRATED B CELLS IN TONGUE SQUAMOUS CELL CARCINOMA Xiaomei Lao, Yujie Liang, Gui-qing Liao Department of Oral and Maxillofacial Surgery, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China Background: Inflammation and desmoplasia were frequently found in tumor microenvironment, former studies showed that they were effective modulators of malignant biological events. Yet, it is poorly understood that how the inflammatory microenvironment and interstitial fibrosis interacts with each other. The study is about to illustrate the degree ofinflammationand interstitial fibrosisin tongue squamous cell carcinoma (TSCC), and how they act to affect the outcome of TSCC. Material and methods: Tissue samples from 93 cases of TSCC and paired tumor-adjacent nonneoplastic tongue epithelium, 14 cases of epithelial dysplasia were used. Interstitial collagen fibers were assessed using Masson’s trichrome stain. Immunohistochemical identification of carcinoma associated fibroblasts (CAFs) and stroma-infiltrating B cells were done through α-smooth muscle actin (α-SMA), vimentin, desmin and CD19 respectively.The clinicopathological significance and the overall survival of TSCC patients were statistically analyzed. Results: We found no CAFs or CD19+ B cells in the stroma of the epithelial dysplasia samples or paired tumor-adjacent non-neoplastic tongue epithelium samples, whereas in the TSCC stroma, and they appeared regularly. The distribution of interstitial collagen fibers and CAFs were closely related to the T stage of primary cancer, And high CD19+ B cells together with low CAFs infiltration were found to be associated with favorable prognosis in TSCC. Conclusions: Inflammatory and interstitial fibrotic microenvironment co-exist in TSCC, both of certain effects on the disease outcome respectively or perhaps collectively, exactly how they affects each other and the TSCC is yet to be investigate.

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IAOO Abstract Issue PP136. MALIGNANT PROGRESSION IN SALIVARY DUCT CARCINOMA EX PLEOMORPHIC ADENOMA: GENOMIC FEATURES IN EACH PHASE Fernanda Viviane Mariano1, Rogério de Oliveira Gondak2, Ricardo Della Coletta3, Oslei Paes de Almeida3, Luiz Paulo Kowalski4, Ana Cristina Victorino Krepischi5, Albina Altemani1. 1. Pathology Department, Faculty of Medicine -UNICAMP, Campinas-SP, Brazil 2. Pathology Department, Faculty of Santa Catarina (UFSC), Florianópolis-SC, Brazil 3. Oral Pathology Department, Piracicaba Dental School - UNICAMP, Piracicaba-SP, Brazil 4. Head and Neck Surgery Department, AC Camargo Cancer Center, São Paulo-SP, Brazil 5. Department of Genetics and Evolutionary Biology, Institute of Biosciences, USP, São Paulo-SP, Brazil Introduction: Salivary duct carcinoma ex pleomorphic adenoma (SDCEPA) is the most common type of carcinoma arising from pleomorphic adenoma (PA). SDCEPA arises within the PA and progresses invading beyond its capsule. To the best of our knowledge, the genomic profile of SDCEPA during tumor progression has not been studied. Purpose: The aim of this study was to investigate the copy number alterations associated with tumor progression in SDCEPA. Method: Nine cases of SDCEPA were evaluated by array-CGH using a 180K platform. Results: SDCEPA was classified as intracapsular (IC- two cases), minimally invasive (MI- two cases) and frankly invasive (FI- five cases). Both IC cases showed different copy number alterations involving the chromosomes: 5, 6, 8, 9, 10, 12, 14, 16, 17, 22. 8p23.3p11.23 loss was identified in both. Amplified genes as MLLT6, LASP1, CDK12, ERBB2, and KDM5A were found. One MI case showed 6q12q27 loss and 12p13.33q24.33 gain. FI cases presented the highest number of copy number alterations involving the chromosomes: 1, 2, 3, 6, 8, 9, 15, 17, 18. 1q21.1q44 gain and 6q12q27 loss were identified in 2/5 FI cases, in addition to CDK12 and ERBB2 amplifications. Conclusions: Somatically acquired copy number alterations, mainly amplifications, can be important for the initial step of the carcinogenesis of SDCEPA. The chromosome 12 gain suggests its participation in this early stage of tumor progression. In advanced tumors, there is an increased number of copy number alterations, of which some could be linked to the aggressive phenotype, particularly 1q21.2q44 gain (FAPESP: 2011/23204-5, 2011/23366-5). PP137. NEUTROPHILS, LYMPHOCYTES, AND THEIR PRODUCTS IN ORAL CARCINOMA – A PAIRED CASE-CONTROL PILOT STUDY Patrícia Caldeira1, Érica Vieira2, Alexandre SoU.S.A3, Antônio Teixeira-Júnior2, Maria Cássia Aguiar1 1. Department of Oral Surgery and Oral Pathology, Scool of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil. 2.Interdisciplinary Laboratory of Medical Investigation, School of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil. 3.Department of Surgery, School of Medicine and Head and Neck Surgery, Instituto Alfa de Gastroenterologia, Hospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil. Introduction: Neutrophils may exert important roles within the tumoral environment. A high number of neutrophils in blood and in tumor, and high neutrophil/ lymphocyte ratio were associated with poor clinical outcome in many cancer types, including those of the head and neck. Purpose: To compare the blood count of neutrophils CD66+, lymphocytes CD4+ and CD8+, the neutrophil / lymphocyte ratio, and arginase-1, IL-10, TNF, and IFN expression between patients with oral squamous cell carcinoma and matched healthy individuals. Method: Blood was collected from 13 patients with a biopsy-proven diagnosis of oral squamous cell carcinoma, previous to treatment, as well as from 13 healthy controls matched by sex, gender, and smoking habit. Immunofluorescence staining for CD66, CD4, CD8, arginase-1, IL-10, TNF, and IFN was evaluated by flow cytometry. Shapiro-Wilk normality test was employed. Wilcoxon and t tests were used for statistics and significance was set as 0.05. Results: Patients presented higher percentage (p10% the case was judged to be positive. The proportion of positive neoplastic cells was assessed according to a two-tiered scale: >10% to 50%, and >50% positive cells. Results: Thirty PA (75%) had >50% of positive cells, six (15%) had between 10% and 50% of positive cells and four (10%) were negative. Twelve residual PA (54%) had >50% of positive cells; five (23%) had between 10% and 50% of positive cells; five (23%) were negative. Seven CXPA (16%) had >50% of positive cells; six (14%) had between 10% and 50% of positive cells; thirty one (70%) were negative. Conclusion: PLAG1 is modulator gene in PA, but its expression is lost when the PA undergoes malignant transformation. Possibly the carcinoma acquires activation of other pathways independent of PLAG1 function. PP165. HIGHLY ACTIVE ANTIRETROVIRAL THERAPY MAINTAINS THE POPULATION OF CD1A+ AND CD83+ DENDRITIC CELLS IN THE ORAL MUCOSA FROM HIV-1+ PATIENTS Fernanda Viviane Mariano1, Rogério Gondak2, Thais Mauad3, Ana Noronha4, Luiz Kowalski4, Pablo Vargas5 1. Pathology Department, Faculty of Medicine – State University of Campinas (FCM/UNICAMP), Campinas-SP, Brazil 2. Pathology Department, University of Santa Catarina (UFSC), Florianópolis-SC, Brazil 3. Pathology Department, Medicine School - University of São Paulo (FMUSP), São Paulo-SP, Brazil 4. Head and Neck Department, AC Camargo Cancer Center, São Paulo-SP, Brazil 5. Oral Pathology Department, Piracicaba Dental School – State University of Campinas (FOP/UNICAMP), Piracicaba-SP, Brazil Introduction: Dendritic cells (DCs) may have important roles in the course of Human Immunodeficiency Virus (HIV) infection, including the probable initial uptake of HIV, transmission to the lymph nodes and subsequent transfer to T cells. Highly active antiretroviral therapy (HAART) administration that is effective in controlling HIV-1 replication should be associated with improvement in innate immune parameters. However, the effect of HAART on innate immune cells has not been well established. Purpose: To quantify and compare the expression of DCs in the tongue mucosa of HIV-1 patients on HAART, HIV-1 patients without HAART and HIV-negative patients, using autopsy material. Method: CD1a and CD83 antibodies were used to identify and quantify LCs in tongue tissue by immunohistochemistry of 15 HIV-1 patients (5 on HAART and 10 without HAART), and 10 tongues from HIV-negative control patients. Quantification was performed by means of conventional morphometry and the results were expressed as positive cells per area of epithelium. Results: The HIV-1 patients without HAART presented a lower density of CD1a+ cells (P < 0.001) and CD83+ cells (P ≤ 0.001) in the tongue compared to the HIV-1 patients on HAART. However, no differences in any of the markers were found when HIV-1 patients on HAART were compared with the control group [CD1a+ cells (P = 0.229) and CD83+ cells (P = 0.547)]. Conclusion: HAART administration to HIV-1-infected patients maintained the population of Langerhans cells in the tongue and consequently led to an improvement in immune function. PP166. MICRORNA EXPRESSION PROFILE RELATED TO MAST CELL ACTIVATION AND ANGIOGENESIS IN SALIVAR GLAND TUMMORS. Poliana Ramos Braga Santos1, Claudia Malheiros Coutinho–Camillo2,Fernando Augusto Soares2, Deise Souza Vilas Boas3, Clarissa Araújo Gurgel1, Jean Nunes dos Santos4 1. School of Dentistry, Federal University of Bahia, Brazil 2. Camargo Cancer Center, São Paulo, Brazil 3. Institute of Health Sciences, Federal University of Bahia, Brazil 4. Oral Surgical Pathoogy Laboratory, School of Dentistry Federal University of Bahia, Brazil Introduction: MicroRNA is a short nucleotide sequence with regulatory functions that could show an aberrant pattern of expression in different neoplasms. E220

IAOO Abstract Issue Purpose: This study evaluated profile expression of six microRNAs: miR-9, miR-16, miR-17, miR-132, miR-195 and miR-221 related to mast cells activation and angiogenesis in salivary gland tumors and normal salivary glands. Method: Expression profile using quantitative real-time RT-PCR of miRNAs was performed on 11 adenoid cystic carcinomas (ACC), 9 mucoepidermoid carcinomas (MEC), and 11 pleomorphic adenomas (PA). In addition, immunohistochemical investigation mast cells (mast cell tryptase) and microvessels (CD-34) was included. Results: It was observed a higher density of mast cells in CME when compared to normal controls or others tumors. Significant difference (p

5th World Congress of the International Academy of Oral Oncology (IAOO).

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