Gene Expression and Metastasis in Head and Neck Cancer

A study of 222 cases of oral or oropharyngeal cancer has yielded startling results about the role of gene expression in metastasis.

Dr Robert Takes, from the Radboud University Nijmegen Medical Centre, the Netherlands, said it is impossible to detect small lymph node metastasis (with current diagnostic tools) in patients with head and neck squamous cell carcinoma. He said it's common for surgeons to unnecessarily operate on the neck even if no metastases have been detected.

Takes and his team correctly predicted the absence of metastasis in 89 percent of cases by looking at 825 relevant genes identified in a previous study. These predictions could result in decreased morbidity without deterioration of oncological outcomes. When metastasis still develops, Takes said, "salvage treatment is still possible."

A combination of biological (gene expression) and clinical factors worked better at predicting metastasis than either alone, making it appear that the signature acts as useful addition that can guide treatment policies.

Head and neck cancers include cancers of the nasal cavity, sinuses, lips, mouth, salivary glands, throat and larynx (voice box).