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

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.