Highlights of the IAOO meeting

Prof Luiz P. Kowalski - IAOO 2015 Chair and Hospital A. C. Camargo, Sao Paulo, Brazil

What are the highlights from the IAOO meeting?

This meeting is a multidisciplinary meeting; we try to involve all the people that are interested in diagnosis, prevention and rehabilitation of patients with oral cancers. Head and neck cancer is 6% of all cancers and oral cancer is about 40% of those tumours so there is a huge number of new patients every year. Unfortunately about 50% of them will die of cancer so we need to do something. It’s a preventable disease, we need to discuss the causes of it because understanding what are the risk factors we can have really good prevention programmes for the entire population. We are discussing here epidemiologic information, the changes in the epidemiology of the disease because we used, in the past, to define high risk patients as patients that are older than 45-50 years, they were smokers, drinkers. Now it’s not true, even younger people that do not smoke, do not drink, they are at risk. We are seeing more and more young patients without these classical characteristics and a lot of investigation work in the last few years and now we understand that several of those cases are related to HPV infection. So this viral infection that can be acquired more or less easily and even without oral sex that is the main risk factor for infection but there are other forms of transmission that can produce oral cancers and those oral cancers are different than the classical ones. So in this meeting we had a lot of discussions about the biology of these new tumours, the difference in treatment that must be discussed that were the object of different clinical trials and possibly in two, three or four years we’ll have a lot of modifications in the treatment.

But of course the discussion was not only related to this epidemiological modification in the profile of the disease but we also are discussing improvements in diagnosis, in the use of optical methods of diagnosis. We are discussing a lot of improvements in the therapy, especially the use of more sophisticated techniques of surgical reconstruction which are planned preoperatively, increasing the efficiency of the reconstruction, reducing the time of the surgical procedure. So there are a lot of new improvements in this area and we have several presentations that discuss this. For example, we are also discussing some improvements in the resection using the robotic surgery. Colleagues from Korea came to us and they are showing very nice surgical procedures to the neck lymph nodes where you can remove the lymph nodes without an incision in the neck. That is very important, especially for the younger patients because they will have their professional life and having a scar on the neck may be something that can compromise their future, professional future. So it’s very important to have in mind that this kind of procedure can be used. There are places where people can be trained and of course with the new technologies that are coming with the new robots, the new machines that we have, we’ll be able to improve the technique.

So there is a lot of new information and we are trying to put together all those people that we would like not only to have progress in diagnosis but also, of course, in the treatment. The congress importantly we divide, I think very well, the discussion in all those topics. One thing that we consider very important is the association of this meeting with the meeting of the Brazilian Histopathology and Oral Pathology. So the dentists that are interested in oral cancer are here and they are discussing their participation in the diagnosis, in the preparation for surgery or for radiation or for chemotherapy, their role in a multidisciplinary team helping us to reduce the number of complications that are related to radiation and chemotherapy.