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Oral Cancer Metastasis pp 75–103Cite as

Prediction of Nodal Metastases from Genomic Analyses of the Primary Tumor

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Abstract

Due to the associated poor prognostic significance, the finding of nodal metastases during the evaluation and staging of patients with head and neck cancer drives therapeutic decisions. Advances in imaging have enabled the detection of smaller cervical metastases with more certainty; however, an unacceptable portion (a minority) of patients with negative clinical and radiographic evaluation for cervical disease actually has metastases upon pathologic evaluation of resected nodes. Clinicians are left in the uncomfortable position of treating cervical nodal basins in patients with greater than 20% risk of metastases based on historical data, despite the fact that, in the majority of patients, this intervention may not be beneficial. This treatment frequently results in patient morbidity and is a health care expenditure that could be redirected if physicians could better predict metastases. On the cellular level, metastasis is a rare event due to its complex nature requiring that the metastatic tumor cells acquire a number of disparate behaviors through gene alterations. Recent data suggest that gene expression profiling of the primary tumor can predict metastatic potential. Because primary tumor biopsies provide adequate material for gene expression profiling, one can imagine that data derived from a diagnostic biopsy could be used to direct therapeutic decisions.

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Authors and Affiliations

  1. Department of Otolaryngology & Department of Cancer Biology, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, 2220 Pierce Avenue, 654 Preston Research Building, Nashville, TN, 37232, USA

    Wendell G. Yarbrough

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  1. Amy S. Whigham
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  2. Wendell G. Yarbrough
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Correspondence to Wendell G. Yarbrough .

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  1. M D Anderson Cancer Center, University of Texas, Holcombe Blvd. 1515, Houston, 77030-4009, U.S.A.

    Jeffrey Myers

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Whigham, A.S., Yarbrough, W.G. (2009). Prediction of Nodal Metastases from Genomic Analyses of the Primary Tumor. In: Myers, J. (eds) Oral Cancer Metastasis. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0775-2_4

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