82 Podium Sessions lished technique during the last twenty years. The reconstruc- tion of soft tissue loss or bones or the combination of both has given the oral cancer patient a superior quality of life. The purpose of the present study was to report on methods of osteosynthesis between the free bone grafts mid the remaining osseous stabs of the maxilla mid the mandible. Materials and Methods: During the years 1999 mid 2004, 22 patients were submitted to ammediate free bone transfer for the reconstruction of surgical defects in the maxillofacial area. Three defects were m the maxilla and 19 in the mandible. The type of free flaps included the fibula m 6 cases and the radial forearm m 16. Osteosynthesis of the bone grafts was randomly performed with nmn plating mid reconstruction plates of 2.7 and 2.3 mm of various lengths and shapes. Results: There was one free bone loss in a patient with maxillary defect. Pseudarthroms occurred m one pataent with mmldibular defect. Severe resorption of a radial graft was observed m a tt~rd. In all of these pahents nmli-plates were used to mmlobilize bony segments. There were four stress fractures ofn~m plates m 8 of the patients to wt~oln this method was apphed. There were no comphcatlons m the 14 patients m which reconstruction plates were used (10 patients with 2.7ram mid 4 with 2.3ram). Conclusion: In extensive mandibular defects reconstruction plating for both fibula and radial free bone grafts provides supe- rior stabthty and uncomphcated bony muon with the remaining mandible. Maxillary and small sized lateral mandibular defects are best reconstructed with radial free bone grafts and nun1 plates seem superior to reconstruction plates. The principles of osteosynthesls should be followed religiously, as m all of our failures Hfferlor technique was the mare causative t~actor. Surgery 1 • 5 ] A population based historical cohort study of squamous cell carcinoma of the upper alveolus and hard palate A. BmaSxned 1, R.W. Nason:, A.A. Abdoh;. ~Department of Oral and Maxfflofac~aI Surge~); Umvers~ty of Mamtoba, Canada, :Department of Su~caI Oncology, Cancer Care Mamtoba, Canada. JDepartment of Surget); Untverstty of Mamtoba, Canada Introduction: The presentation and management of squamous cell carcinoma &the hard palate (HP) and upper alveolus (UA) are samdar. Thus retrospective population-based study evaluates treatment outcome m this relatively rare oral cancer. Materials and Methods: A historical cohort of 62 patients from the cancer registry of the Province o f Manitoba diagnosed wath squamous cell carcinoma between January 1975 and February 2004 were examined. Thtrty-seven cases of previ- ously untreated biopsy-proven squamous cell carcinoma were identified. Results: The ~or epicenter was the upper alveolus m 26 and hard palate m 11. The mean age of the study population was 72.8 years. Twenty-five patients (67?,'0) were females and when documented, 50?,'o used tobacco. Forty-one percent had stage I or II disease, 517,'o stage III or IV, and 8% could not be staged. Treatment included radiotherapy (13.5o/0), surgery (38%), surgery and radiotherapy (24%), and palhahve treat- ment (~4 %). Local recurrence was observed m ten patients with the majority (60%) fating at the prmmry site. The absolute and disease free survival at 5-years was 33?,'o and 62°/0 respectively. The 5-year disease-free survival was 82% for stage I & II and 48% for stage III and IV (P=0.056). Initial treatment modality influenced survival (P=0.001). No patient treated with radiotherapy as a single treatment modality survived 5 years. Disease free survival for patients treated with surgery and surgery and radiotherapy was 69% and 73% at 5 years. Conclusion: Squamous cell carcinoma of the UA an HP differs from other oral cancers in that the patients are relatively older with a high proportion of females, a less evident association with tobacco, and a relatively high number of patients not anlenable to treatment with curative intent. Treatment with surgery, with or without radiotherapy, appears to be necessary for disease control. •0•6• Long term survival in squamous cell carcinoma of the buccal mucosa M.A.S. Tesseroh, A.L. Dommgues, J.G. Vartaman, A.L. Carvalho, J. Magrm, L.E Kowalskl. Head and Neck Sw'gery and Otorhmolaryngolo, gv Department, Centro de Tratamento e Pesqutsa Hospttal do Cancer A C Camargo, S~o Paulo. Brazil Introduction: Squarnous cell carcinoma (SCC) of the buccal mucosa as uncommon m the western world. The natural history and surwval results after different treatment options are slall controvermal m the literature. The mare object of this study was to describe the experience of a single South American restitution m the treatment of these turnouts and to analyse pro~ostac factors. Materials and Methods: A retrospective study was performed mclurhng a seraes of 123 consecuhve patients with SCC of the buccal mucosa, treated from 1954 to 2004. Results: There were 77 (62.6°,;) male patients, with ages ranging from 19 to 86 years (media~ 61). The T stage was: 50 (40.6°,'o) T1/T2 and 72 (58.5%) T3/T4. The N stage was: 70 (56.9%) NO, 52 (42.2°,o) N+. Just 31 patients (25.2%) had ~mours restricted to the buccal mucosa, with the rematrang cases invading other adjacent rotes of the oral cavity, mandible, maxilla or skin. Fifty-one patients (41.5°,'0) underwent surgery, 42 (34.12/0) radiotherapy, 25 (20.3°,'0) combined surgery and radiotherapy and 5 (4.02/0) chemoradiotherapy. Thtrty-nme patients (31.7%) presented tumour recurrences, being local failures the most common (22.8%). The 5-year overall survival was 45%. In the multivariate Cox regression model analysis, treatment with radiotherapy [HR=I.8 (95°,0 CI: 1.1-3.1)] or chemoradiotherapy [HR=4.6 (95% CI: 1.2-18)] and tumour extension to more than 2 sites [HR=2.6 (95% CI: 1.2-5.6)] were identified as the only independent prognostic predictors. Conclusion: This study confirmed a low incidence of SCC of the buccal mucosa m the mstltutlon and, among all variables studieck just treatment modahty and tumour extenmon were independent prognostic factors m this group of patients. The prognosis was tmproved m the 1980"s and 1990"s when surgery alone or combined with postoperative radiotherapy becanle the first therapeutic option m the mshtutlon. • Marginal mandibulectomy for gingivo-buccal complex cancers M.S. Deshpande, K.A. Pathak, R. Agarwal, D.A. Chaukar, R Chaturvedi, R Pal, A.K. D'Cruz. Tata Memorial Hospital, Mumbai. India Introduction: Gmglvo-buccal conlplex cancers comprise of cancers of buccal mucosa, lower alveolus, lower gmglvobuccal sulcus and retro-nlolar tngone. The anatonllcal contmmty of mandible has a profound effect on the cosmehc and functional