Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P65

Oral Presentations	

Comparison of Spindle Cell and
Desmoplastic Melanoma: Similar
Histopathologies With Different Clinical
Behavior
Gregory L. Barinsky, PharmD (Presenter);
Roman Povolotskiy; Soly Baredes, MD; Richard C. Park, MD;
Dylan F. Roden, MD, MPH
Objectives: Spindle cell melanoma (SCM) and desmoplastic
melanoma (DM) are rare subtypes of melanoma that often
present in the head and neck. Distinguishing SCM and DM is
challenging because of many overlapping pathologic features.
We sought to investigate differences in clinical behavior
between SCM and DM.
Methods: The National Cancer Database (NCDB) was queried for cases of SCM and DM from 2004 to 2015. Patient
demographics, pathologic features, and treatment modalities
were compared using univariate analysis. Kaplan-Meier analysis and Cox proportional hazards were used to examine
survival.
Results: SCM (2.6%) and DM (3.8%) composed a small
fraction of all head and neck melanomas. Forty-two percent of
SCM and 54% of DM were located in the head and neck. For
inclusion in the study, 1026 (40.3%) cases of SCM and 1523
(59.7%) met the criteria. Age, gender, race, insurance,
Charlson-Deyo score, T stage, and M stage were not different
between the groups. SCM was more likely to be located on the
face (47.3% vs 43.7%), and DM was more likely to be on the
scalp and neck (46.7% vs 39.7%, P < 0.001). DM was more
often N0 (93.8% vs 91.1%, P = .008) and treated with surgery
plus radiation therapy (RT) (20.2% vs 14.1%, P < .001). Fiveyear overall survival favored DM over SCM (63.5% vs 59.2%,
P =.008). After multivariate regression, DM had borderline
significance for improved survival over SCM (hazard ratio
[HR], 0.88, [0.76-1.01]; P = .06). The addition of adjuvant
radiation trended toward improved survival for DM (HR 0.79;
[0.63-1.01]; P = .055], but not SCM (HR 0.91; [0.67-1.23]; P
= .531). Positive margins increased risk of death (HR 1.48;
[1.22-1.80]; P < .001).
Conclusions: DM is less likely to have nodal metastasis, is
more likely to receive adjuvant RT, and has marginally better
survival than SCM. Adjuvant RT may improve survival in
DM.

A Cross-disciplinary Community
Intervention to Improve Knowledge
Regarding Human Papillomavirus
Vaccination
Brooke Su, MD (Presenter); Maie St. John, MD, PhD
Objectives: The human papillomavirus (HPV) vaccine is
believed to prevent HPV-related oropharyngeal cancer (HPVOPC); however, national uptake of the HPV vaccine among
eligible patients remains low. This project seeks to evaluate
the efficacy of cross-disciplinary educational interventions
between otolaryngologists, primary care providers, and
patients about the importance of HPV vaccination.
Methods: This mixed-methods qualitative research included
structured qualitative interviews with 5 primary care providers
of different specialties regarding HPV knowledge and vaccine
recommendations, used to inform 3 educational presentations
to large primary care practice groups. We also conducted patient
outreach at a large community health fair and free clinic.
Results: Over 50% of primary care providers (including
pediatricians) were unaware of the link between HPV and
OPC, and 75% do not discuss head and neck cancer when they
recommend the vaccine. Best practices for counseling patients
regarding vaccine importance and addressing patient/parent
concerns were identified. Following an educational presentation by an otolaryngologist, all primary care providers reported
that they will change their vaccine recommendation practices
to include HPV-OPC. Fifty-eight subjects were involved in
HPV-OPC outreach at the health fair, 40% of whom were
unaware of the role of HPV in head and neck cancer. All but 6
were amenable to seeking out the vaccine for themselves or
family members after the discussion.
Conclusion: Primary care providers who recommend and
provide the HPV vaccine are largely unaware of its significance to head and neck cancer. Otolaryngologists can play an
important role in educating providers and the public to help
improve HPV vaccination rates.
Deep Learning for Diagnosis of
Oropharyngeal Squamous Cell Carcinoma
Using Computed Tomography Imaging: A
Preliminary Study
Margaret C. Nurimba, MD (Presenter); Vishal Patel, MD;
John Go, MD; Mark Swanson, MD; Niels C. Kokot, MD;
Tamara Noelle Chambers, MD
Objectives: Anatomic imaging alone is rarely used for the
diagnosis of oropharyngeal squamous cell carcinoma (OPSCC)
because non-neoplastic processes involving the lingual and palatine tonsils can mimic malignancy and make discrimination of
early stage disease challenging. The purpose of this study was to
investigate the diagnostic performance of a deep learning algorithm to detect OPSCC on computed tomography (CT) images.
Methods: This retrospective study evaluated CT imaging
from 59 individual subjects (21 controls, 38 cases). Both

Head and Neck

hospital was significantly higher in the GA group (mean = 409
min) compared with the MAC group (mean = 252 min) (P ≤
.0001). Total time in recovery was significantly higher in the
GA group by over an hour (mean = 179 min) than in the MAC
group (mean = 115 min) (P ≤ .0001).
Conclusions: Performing sialendoscopy under MAC demonstrated similar successful outcomes compared with GA, with
significantly lower time in hospital and recovery. Our data and
experience suggest that while not all sialendoscopies are
appropriate for MAC, it is suitable, safe, and more efficient in
most cases.

P65
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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