Sander R. van Hooff, from the University Medical Center Utrecht in the Netherlands, and colleagues used a diagnostic DNA microarray to evaluate a previously reported multigene signature for distinguishing metastasizing from non-metastasizing (N0) OSCC and OPSCC in 222 patients from all head and neck oncology centers in the Netherlands.

The researchers found that the negative predictive value was 72 percent for the diagnostic signature in the entire validation cohort. In a subset of early-stage (cT1 to T2N0) OSCC (101 patients), the signature performed well, with a negative predictive value of 89 percent.

"Combining current clinical assessment with the expression signature would decrease the rate of undetected nodal metastases from 28 to 11 percent in early-stage OSCC. This should be sufficient to enable clinicians to refrain from elective neck treatment," the authors write. "A new clinical decision model that incorporates the expression signature is therefore proposed for testing in a prospective study, which could substantially improve treatment for this group of patients."

One author disclosed financial ties to the diagnostic company Agendia.

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