94 Oral and Symposium abstracts, Saturday 19 May

Keywords: quality of life, University of Washington quality oflife scale, validation, function

O108 Predictors of quality of life after treatment for oralcancer

T. Gurney*, D. Eisele, L. Orloff, S. Wang. University ofCalifornia, United States

Introduction: The purpose of this study was to analyze thevarious demographic, treatment, and outcome variables thatmay affect quality of life following oral cancer treatment. Across-sectional study of patients previously treated for oralcavity and oropharyngeal cancers was performed.Methods: All patients previously treated for oral cavity andoropharynx carcinoma seen at a tertiary head and neck surgeryclinic over a four month period were requested to participatein this study. Participants completed the University of MichiganHead & Neck Specific Quality of Life questionnaire, which is avalidated survey instrument that analyzes the effects of cancertreatment on 4 domains, including eating, speech, emotionand pain. Survey results were analyzed with respect to variouspatient demographic, treatment, and outcome parameters todetermine variables that predicted perceived quality of lifedifferences.Results: Eighty-seven patients eligible for the study completedquestionnaires. The majority of study subjects were male(62%). Analysis of the various treatment modalities receivedby patients in this study revealed that a history of surgerydid not significantly impact perceived quality of life in anydomain. On the other hand, a history of radiation treatment orsurgery with radiation treatment predicted significantly poorerquality of life scores in the domain of eating and the domainsof eating and speech, respectively (p < 0.05). Other predictorsof poorer quality of life scores included advanced stage (eatingdomain), gastrostomy-tube dependence (eating, speech, andemotion domains), surgical complications (eating and emotiondomains), and cancer recurrence (eating, emotion, and speechdomains).Discussion: Quality of life among oral cancer patients isnegatively affected by advanced stage, radiation treatment,surgery with radiation treatment, complications after surgery,gastrostomy-tube dependence, and cancer recurrence. Knowl-edge of negative predictors of quality of life can allowphysicians to provide better supportive care where appropriatefor oral cancer patients.Keywords: oral cancer, quality of life, radiation therapy

O109 Defect characteristics and type of reconstructionas predictors of speech and swallowing followingsurgery for oral and oropharyngeal cancer

A. Schache*, N. Kalavrezos, J. Roe, L. Newman, C. Hopper.University College London Hospitals, United Kingdom

Speech and swallowing function in postsurgical head and neckcancer patients may be affected by the degree of resection andthe mode of reconstruction. Articulation and the oral stage ofthe swallow are generally more severely impaired, although thepharyngeal stage of the swallow may be affected if resectionincludes the tongue base.This study involves subjective and video swallow assessmentin a sample of 40 patients who received surgery as primarytreatment for intraoral cancer at UCLH. Our aim was tocorrelate the functional outcome to the site and the extent ofthe resection of the oral cavity, to the type of reconstructionand to postoperative radiotherapy.There were four categories of defect depending on the site ofresection:1. lateral-anterior defects including the lateral floor of mouth,

buccal vestibule and/or the mandible

2. central-anterior defects including the anterior floor ofmouth, labial vestibule and/or the mandible (intercaninalsegment)

3. posterior-lateral defects including the retromolar area,lateral pharyngeal wall and/or the posterior mandible

4. central defects including the tongue and the floor of mouthMost of the defects were reconstructed with a free vascularisedflap whereas in few cases a pedicled regional flap was used. Acombination of free and pedicled flap was used in one patient.All patients included had a subjective speech assessment inthe immediate postoperative period whereas a video swallowwas performed in most cases as a baseline assessment prior tothe commencement of radiotherapy. The rest of the patientshad a video swallow in the post-radiotherapy set up. Theresults of the subjective and video swallow assessment arecorrelated to the site, the extent of the resection and the typeof reconstruction. The impact of postoperative radiotherapy onoral functions is also discussed.Keywords: speech, swallow, oral cancer, reconstruction

Basic science III

O110 Increased CK19 expression correlated withpathological differentiation grade and prognosis inoral squamous cell carcinoma patients

L. Zhong*, Z. Zhang, C. Zhang, W. Chen. Shanghai Jiao TongUniversity, China

Objective: To investigate cytokeratin 19 (CK19) expressionin oral squamous cell carcinoma (OSCC) tissue as well asits correlation with pathological differentiation grade andprognosis.Materials and Methods: Cancerous and distant tissues from33 primary OSCC patients were collected during surgicaloperation. Each sample was divided into two parts, one forCK19 protein detection using immunohistochemistry, and theother for CK19 mRNA level detection of relative quantificationusing fluorescent real-time RT-PCR.Results: CK19 positive rate in cancerous tissue was 90.9%(30/33) detected using immunohistochemistry, which was sig-nificantly higher than that in distant tissue (15.2%, 5/33) by Chi-square test (P< 0.001). CK19 positive score in cancerous tissuewas also significantly higher than that in the correspondingdistant tissue by Paired samples t-test (P< 0.001). Patientswith positive CK19 expression in distant tissue had highertumor recurrence rate (P= 0.008) and lower survival rate(P= 0.015) than those with negative CK19 expression in distanttissue. Using fluorescent real-time RT-PCR, CK19 mRNA levelin cancerous tissue was 2.21 folds higher than that in distanttissue (P= 0.020). CK19 expression correlated significantly withpathological differentiation grade, which was detected notonly using immunohistochemistry (P= 0.002) but also usingfluorescent real-time RT-PCR (P= 0.025), poorer differentiatedindicating higher CK19 positive score and CK19 mRNA level.Conclusions: Increased CK19 protein expression and genetranscription in OSCC tissue correlate significantly withpathological differentiation grade. Positive CK19 expression indistant tissue suggests a higher tumor recurrence rate and alower survival rate.Keywords: cytokeratin 19, oral squamous cell carcinoma,pathological differentiation grade, prognosis

O111 Towards a rapid assay for detection of residualcancer

X. Huang*. King’s College, United Kingdom

Introduction: Molecular detection of residual cancer mayimprove prediction of cases likely to develop a recurrence aftersurgery. The p53 phage plaque assay provides the current goldstandard method for detection of residual cancer. However,