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. 2019 Apr;41(4):871-879.
doi: 10.1002/hed.25473. Epub 2019 Jan 29.

Performance of a 31-gene expression profile test in cutaneous melanomas of the head and neck

Brian R Gastman  1 , Jonathan S Zager  2 , Jane L Messina  3 , Robert W Cook  4 , Kyle R Covington  4 , Brooke Middlebrook  4 , Pedram Gerami  5   6   7 , Jeffrey D Wayne  5   8 , Sancy Leachman  9 , John T Vetto  10
Affiliations

Performance of a 31-gene expression profile test in cutaneous melanomas of the head and neck

Brian R Gastman et al. Head Neck. 2019 Apr.

Abstract

Background: We report the performance of a gene expression profile test to classify the recurrence risk of cutaneous melanoma tumors of the head and neck as low-risk Class 1 or high-risk Class 2.

Methods: Of note, 157 primary head and neck cutaneous melanoma tumors were identified. Survival analyses were performed using Kaplan-Meier and Cox methods.

Results: Gene expression profile class and node status stratified tumors into significantly different 5-year survival groups by Kaplan-Meier method (P < .0001 for all end points), and both were independent predictors of recurrence in multivariate analysis. Overall, 74% of distant metastases and 88% of melanoma-specific deaths had Class 2 risk.

Conclusion: The gene expression profile test identifies cases at increased risk for metastasis and death independent of a clinically or pathologically negative nodal status, suggesting that incorporation of this molecular tool could improve clinical management of patients with head and neck cutaneous melanoma, especially in those with a negative sentinel lymph node biopsy.

Keywords: cutaneous melanoma; gene expression profiling; metastasis; prognosis; staging.

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Conflict of interest statement

R.W.C. and K.R.C. are employees and stock option holders of Castle Biosciences, Inc. J.S.Z. and P.G. are consultants for Castle Biosciences, Inc. B.R.G., P.G., and J.V. are on the Speaker Bureau for Castle Biosciences, Inc.

Figures

Figure 1
Figure 1
Kaplan‐Meier analysis of recurrence‐free (RFS), distant metastasis‐free (DMFS), overall survival (OS), and melanoma‐specific survival (MSS) by gene expression profile (GEP) class. RFS, DMFS, OS, and MSS rates for patients with cutaneous melanoma located in the head and neck (n = 157) using molecular GEP subclassification or nodal status in Kaplan‐Meier analysis. Tables below curves show the number of patients with each GEP class or a sentinel lymph node status, 5‐year survival rates for the outcome with 95% confidence intervals, and number of events with percentages experiencing the event. P‐values determined by log rank test for either all comparisons of GEP class or nodal status [Color figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
Kaplan‐Meier analysis of recurrence‐free (RFS), distant metastasis‐free (DMFS), overall survival (OS), and melanoma‐specific survival (MSS) outcomes by combined gene expression profile (GEP) and nodal risk classification. RFS, DMFS, OS, and MSS rates for patients with cutaneous melanoma located in the head and neck (n = 157) using molecular GEP class and clinical nodal status in Kaplan‐Meier analysis. Tables below curves show the number of patients with each GEP class and a sentinel lymph node status combination, 5‐year survival rates for the outcome with 95% confidence intervals, and number of events with percentages experiencing the event. P‐values determined by log rank test for all comparisons
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