Researchers at Henry Ford Hospital in Detroit say that developing a molecular fingerprint for head and neck cancer tumours could help improve diagnosis and treatment for this deadly and often-times disfiguring form of cancer.
Their new study has taken the first step towards doing that by identifying five risk factors for late-stage head and neck cancer - two genes, tumor grade, and vascular invasion and location of the tumour. Race, however, was not an independent predictor for late-stage disease, contrary to other research findings. In fact, 88 per cent of the African American patients in the study had some form of insurance.
The study looked 689 Henry Ford patients from 1986 to 2005 with a primary diagnosis of head and neck squamous cell carcinoma (HNSCC). Most notably, 42 per cent of the study group was African American.
It examined 23 non-genetic patient risk factors including race, martial status and family history, and also looked at patients’ tumour biology by examining tumour DNA for 113 genes from 2,166 tissue blocks. While previous studies have suggested African Americans are more likely to have late-stage disease with worse survival, the Henry Ford multivariate analysis found that race is not a risk factor for late-stage HNSCC. The study also found that the site of the tumour in head and neck cancer had an impact on disease stage.
Patients with cancer in the oropharynx, which lies behind the oral cavity, and those with cancer in the hypopharynx, located at the bottom part of the pharynx, are more likely to have late-stage disease. Poor tumour grade also placed patient at greater risk for late-stage disease. The researchers also identified two genes that signalled late-stage HNSCC.
These initial findings will be presented by lead author Dr. Maria J. Worsham on Oct. 28 during a panel discussion at the American Head and Neck Society 2010 Research Workshop in Arlington, VA.
