Medical researchers in India have pinpointed a set of five biological markers that they say could help doctors predict which oral cancers are likely to have spread to lymph nodes and guide treatment decisions.

The scientists in Bengal who collaborated with cancer specialists in Mumbai said doctors could use these markers to classify oral cancer patients who need aggressive treatment strategies and those who could be spared unnecessary neck dissections.

Oral cancer is among the most common malignancies in India and medical studies have suggested that only between 40 to 60 per cent of oral cancer patients survive for five or more years even after treatment.

Patients diagnosed with cancers that have spread to the lymph nodes through a process called metastasis have poorer chances of five-year survival.

“We’ve found five biomarkers for lymph node metastasis,” said Partha Majumder, distinguished professor at the National Institute of Biomedical Genetics, Kalyani, who led the research. “Doctors could plan treatment depending on the presence of absence of these biomarkers.”

Their findings have been accepted for publication in the International Journal of Cancer.

At present, when surgeons operate on patients with oral cancer, they typically dissect regions of the neck to find out if the cancer has spread to the lymph nodes in the neck, the most common metastatic site for oral cancer.

“Patients could be assessed for biomarkers before the surgery,” Majumder said. “The absence of biomarkers could help spare patients exploratory dissection of the neck. The presence of a biomarker would point to the need for aggressive treatment options.”

Majumder and his colleagues at NIBMG collaborating with oncologists at the Tata Memorial Centre Advanced Centre for Treatment Research and Education in Cancer analysed the genetic makeup, the status of lymph nodes and the treatment outcomes in 72 patients with oral cancer.

They found that patients with lymph node metastasis were likely to have mutations in three specific genes and in other genes involved in a cell division pathway and DNA-repair process.

“We could use the relevant mutations in the three genes and two pathways as five biological markers for lymph node metastasis,” Nidhan Biswas, a computational biologist at NIBMG.

However, the researchers say the findings would need to be validated through a larger set of patients for clinical applications.