Consensus conference on salivary gland tumors Adenoid-cystic carcinoma and high-grade neoplasms A common commitment towards the future October 23rd-24th 2014, School of Medicine, University of Brescia (Italy) Consensus conference on salivary gland tumors Adenoid-cystic carcinoma and high-grade neoplasms Dear Colleagues, The challenging management of salivary gland malignancies asks for a multidisciplinary approach. In the last few years the knowledge in the field of basic science has grown rapidly, and is probably becoming the driver for therapeutic choices in the future. In keeping with this concept, the present conference wants to gather experts in the fields of Pathology, Imaging, Surgery (ENT and Maxillo-Facial Surgeons), Radiation and Medical Oncology to prepare for the future. Together we will delineate by consensus the management of “problematic” salivary gland tumors for the next years. This will be a 2-day consensus conference, with the first day dedicated to adenoid-cystic carcinoma, and the second day focused on high-grade salivary gland malignancies. Three topics for discussion (diagnosis, therapeutic approach to the primary lesion, treatment of recurrent/metastatic disease) will characterize each day of the meeting. Each session will consist of two parts: in the first, the “state of the art” will be defined by experts, whereas in the second part the panelists and audience will try to reach a consensus. For each topic (diagnosis, treatment of primary tumor and metastatic disease), a chairman and experts will be identified. They will be in charged of writing a document that will be submitted to the panelists for comments, at least 6 months before the date of the meeting. The final document will be discussed during the meeting between experts and the audience to reach a consensus. Congress Directors Adel El-Naggar, Department of Pathology, M.D. Anderson Cancer Center, Houston, USA Ehab Hanna, Department of Head and Neck Surgery, M.D. Anderson Cancer Center, Houston, USA Lisa Licitra, Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Roberto Maroldi, Department of Radiology, University of Brescia, Italy Piero Nicolai, Department of Otorhinolaryngology, University of Brescia, Italy Scientific Secretariat Laura Locati, Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy Davide Lombardi, Department of Otorhinolaryngology, University of Brescia, Italy Ester Orlandi, Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy William Vermi, Department of Pathology, University of Brescia, Italy Faculty International Faculty Ian Casselman, Department of Radiology, A.Z. St.-Jan Hospital, Bruges, Belgium Jurgen Debüs, Department of Radiation Oncology, University of Heidelberg, Germany Isabel Fonseca, Department of Head Neck Pathology, University of Lisbon, Portugal David G. Pfister, Head and Neck Oncology Service, Memorial Sloan-Kettering Cancer Center, New York, USA Goran Stenman, Department of Pathology, Sahlgrenska Cancer Center, University of Göteborg, Sweden Carla M. van Herpen, Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands Vicent Vander Poorten, Department of Head Neck Surgery, University of Leuwen, Belgium Philippe Vielh, Department of Pathology, Institut Gustave Roussy, Paris, France Randal Weber, Department of Head Neck Surgery, Houston, USA Faculty Italian Faculty Mario Airoldi, Department of Medical Oncology, University of Turin Antonino R. Antonelli, Department of Otorhinolaryngology, University of Brescia Alfredo Berruti, Department of Medical Oncology, University of Brescia Francesco Bertagna, Department of Nuclear Medicine, University of Brescia Mario Bussi, Department of Otorhinolaryngology, University “S.Raffaele”, Milan Flavio Crippa, Nuclear Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Fabio Facchetti, Department of Pathology, University of Brescia Carlo Fallai, Department of Radiation Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Davide Farina, Department of Radiology, University of Brescia Piero Fossati, Department of Radiation Oncology, National Center for Adrotherapy “CNAO”, Milan Raffaele Giubbini, Department of Nuclear Medicine, University of Brescia Gioacchino Giugliano, Department of Head and Neck Surgery, Istituto Europeo di Oncologia, Milan Marco Guzzo, Head and Neck Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Stefano Magrini, Department of Radiation Oncology, University of Brescia Ugo Pastorino, Thoracic Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Cesare Piazza, Department of Otorhinolaryngology, University of Brescia Paolo Potepan, Department of Head and Neck Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Giuseppe Sanguineti, Department of Radiation Oncology, National Cancer Institute “Regina Elena”, Rome Enrico Sesenna, Department of Maxillofacial Surgery, University of Parma Giuseppe Spriano, Department of Head and Neck Surgery, National Cancer Institute “Regina Elena”, Rome Barbara Valeri, Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan Program 08.00-08.10 Introduction: P. Nicolai 08.10-08.25 Honorary lecture: The history of adenoid-cystic carcinoma A. R. Antonelli Day 1, October 23rd 2014: Adenoid-cystic carcinoma (ACC) 08.25-08.45 Lecture: Overview on molecular features of ACC and their impact on treatment. (A. El-Naggar) (20’) 08.45-09.45 1st Session: DIAGNOSIS Chairman: A. El-Naggar Panelists: I. Casselman, F. Crippa, F. Facchetti, B. Valeri - Histopathologic definition, histologic subtypes and aggressive variants (G. Stenman) (15’) - FNAB and histology: the most frequent missclassifications (I. Fonseca) (10’) - Overview on perineural spread: cellular and molecular mechanisms (W. Vermi) (10’) - The role and limits of imaging (CT, MRI, and PET) in treatment planning (R. Maroldi- R. Giubbini) (20’) 09.45-10.45 Consensus on: - Histopathologic diagnostic criteria - Diagnostic imaging 10.45-11.00 Coffee-break Day 1, October 23rd 2014 11.00-12.30 2nd Session:TREATMENT OF THE PRIMARY LESION Chairman: V. Vander Poorten Panelists: P. Fossati, G. Giugliano, S. Magrini, L. Licitra, D. Lombardi - Indications, suggestions and problems in surgical treatment of minor salivary glands adenoid-cystic carcinoma (P. Nicolai) (15’) - Indications, suggestions and problems in surgical treatment of major salivary glands adenoid-cystic carcinoma (E. Hanna) (15’) - Reconstructive issues and facial reanimation (C. Piazza, E. Sesenna) (20’) - Indications to RT in an adjuvant and exclusive setting (+/- CHT) (E. Orlandi) (20’) - Carbon-ion therapy (J. Debüs) (20’) 12.30-13.45 Consensus on: - Treatment of the primary lesion - Reconstruction and facial reinnervation - Adjuvant and curative RT +/- CHT 13.45-14.45 Lunch 14.45-16.00 3rd Session: FOLLOW-UP AND RECURRENT/METASTATIC DISEASE Chairman: R. Weber Panelists: E. Hanna, E. Orlandi, M. Airoldi, D. Farina, F. Bertagna - The role of imaging (CT, MRI and PET) in the post-treatment surveillance (I. Casselman) (15’) - The role of surgery in the treatment of local relapse (V. Vander Poorten) (15’) - The role of reirradiation in the treatment of local relapse (C. Fallai) (15’) - The role of surgery in the treatment of lung metastasis (U. Pastorino) (10’) - Therapy for locally advanced, recurrent and metastatic disease (D. G. Pfister) (20’) 16.00-18.00 Consensus on: - Follow-up strategy - Indications for surgery and/or reirradiation for recurrent primary lesions - Indications for surgery for lung metastases - Medical treatment for metastatic disease Day 2, October 24th 2014: High-grade salivary gland tumors (High-grade MEC, Salivary duct carcinoma, Carcinoma ex-pleomorphic adenoma, Adenocarcinoma) 08.00-08.20 Lecture Overview on molecular features of high-grade salivary gland tumors and their impact on treatment (A. El-Naggar) (20’) 08.20-09.30 1st Session: DIAGNOSIS Chairman: F. Facchetti Panelists: I. Casselman, R. Giubbini, A. El-Naggar, B. Valeri - Chromosomal rearrangements and fusion oncogenes (G. Stenman) (20’’) - The role of FNA in diagnosis and molecular testing of salivary gland cancers (P. Vielh) (15’) - Histopathologic definition and differential diagnosis (I. Fonseca) (15’) - The role and limits imaging (CT, MRI and PET) in treatment planning (D. Farina - F. Crippa) (15’) 09.30-10.40 Consensus on: - Histopathologic diagnostic criteria - Diagnostic imaging 10.40-10.55 Coffee-break 10.55-11.50 2nd Session:TREATMENT OF THE PRIMARY LESION AND THE NECK Chairman: M. Bussi Panelists: M. Guzzo, J. Debüs, A. Berruti, L. Locati - Indications, suggestions, and problems in surgical treatment of high-grade salivary gland tumors (V. Vander Poorten) (15’) - Indications, suggestions, and problems in surgical treatment of the neck in high-grade salivary glands tumors (G. Spriano) (15’) - Indications for RT in an adjuvant and exclusive setting (+/- CHT) (G. Sanguineti) (20’) Day 2, October 24th 2014 11.50-13.10 Consensus on: - Surgical indications for the treatment of primary lesions and the neck - Indications for adjuvant treatment and exclusive RT (+/-ChT) 13.10-14.10 Lunch 14.10-15.10 3rd Session: FOLLOW-UP AND RECURRENT/METASTATIC DISEASE Chairman: L. Licitra Moderators:E. Hanna, C. Fallai, R. Maroldi/D. Farina, F. Bertagna - The role of imaging in the post-treatment surveillance (P. Potepan - F. Crippa) (15’) - The role of surgery in the treatment of loco-regional relapse (R. Weber) (15’) - The role of reirradiation in the treatment of loco-regional relapse (S. Magrini) (15’) - Systemic therapy for locally advanced, recurrent and metastatic disease (C. M. Van Herpen) (15’) 15.10-16.30 Consensus on: - Follow-up strategy - Indications to surgery and/or re-irradiation for recurrent primary lesions - Systemic treatment for metastatic disease 16.30-17.00 Closing remarks General informations Language The official language will be English. ECM/CME The course will ECM and CME accredited. Hotel booking For information and booking please contact the Organizing Secretariat. Course Venue School of Medicine - University of Brescia Insurance Via Valsabbina, 19 - 25121 Brescia - Italy Organizers do not accept responsability for individual medical, travel or personal expenses. Registrants are strongly advised to take out their own personal insurance policies. Cancellation Policy In the unusual circumstance that the course is cancelled, two weeks notice will be given and the fee will be refunded in full. The Organizers are not responsible for any airfare, hotel or other costs incurred. Organizing Secretariat Servizi C.E.C. Srl - Via G. Verdi, 18 - 24121 Bergamo - Italy Phone +39.(0)35.249899 Fax. +39.(0)35.237852 e-mail: [email protected] www.servizicec.it How to reach the University of Brescia-School of Medicine By car Highway A4 Milano-Venezia. • Exit Brescia Ovest; at the exit follow Tangenziale Ovest proceed along Tangenziale Nord. Follow for Stadio or Ospedale, proceed along via Oberdan. Go through, turn left for Via Triumplina and after 800 mt. turn right through Via Branze, on your left there’s the School of Engineering and on the right hand there is School of Medicine. • Exit Brescia Centro; at the exit take the Tangenziale Sud follow the road signs that take to Tangenziale. Please follow the one with Val Trompia, Milano or Bergamo. Arrived in the Tangenziale, proceed along till the road sign Tangenziale Ovest or Val Trompia. Now drive thorugh Tangenziale Ovest and go ahead to Tangenziale Nord, follow the road signs Stadio or Ospedale. 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