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Do patients with p16-positive oropharyngeal squamous cell carcinoma get more bone metastasis than p16-negative patients?

  • A S Harris (a1), R G Thomas (a1) and C D Passant (a1)

Oropharyngeal squamous cell carcinoma is thought to rarely metastasise to bone. This study hypothesised that in p16-positive disease there is a significant incidence of bony metastasis.


This was an ambispective cohort review. All patients with oropharyngeal squamous cell carcinoma diagnosed and treated at one centre were included.


A total of 180 consecutive patients were identified over 5 years. Fifteen patients were excluded because of lack of p16 status, none of whom had bony metastasis. The final analysis included 165 patients: 48 (29.09 per cent) in the p16-negative group and 117 (70.91 per cent) in the p16-positive group. Ten patients (8.55 per cent) in the p16-positive group developed bony metastasis, compared with zero in the p16-negative group; this difference was statistically significant (p = 0.036).


Expression of p16 was associated with an increased incidence in bony metastasis in this cohort. This is the first study to explore this specific question.

Corresponding author
Address for correspondence: Mr Andrew S Harris, Ear, Nose and Throat Department, Royal Gwent Hospital, Cardiff Road, Newport NP20 2UB, Wales, UK E-mail:
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Presented as a poster at the British Association of Head and Neck Oncology (‘BAHNO’) Annual Scientific Meeting, 12 May 2017, London, UK.

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1Takes, RP, Rinaldo, A, Silver, CE, Haigentz, M Jr, Woolgar, JA, Triantafyllou, A et al. Distant metastases from head and neck squamous cell carcinoma. Part I. Basic aspects. Oral Oncol 2012;48:775–9.
2Ferlito, A, Shaha, AR, Silver, CE, Rinaldo, A, Mondin, V. Incidence and sites of distant metastases from head and neck cancer. ORL J Otorhinolaryngol Relat Spec 2001;63:202–7.
3Kowalski, LP, Carvalho, AL, Priante, AV, Magrin, J. Predictive factors for distant metastasis from oral and oropharyngeal squamous cell carcinoma. Oral Oncol 2005;41:534–41.
4Gooi, Z, Chan, JY, Fakhry, C. The epidemiology of the human papillomavirus related to oropharyngeal head and neck cancer. Laryngoscope 2016;126:894900.
5Wittekindt, C, Gültekin, E, Weissenborn, SJ, Dienes, HP, Pfister, HJ, Klussmann, JP. Expression of p16 protein is associated with human papillomavirus status in tonsillar carcinomas and has implications on survival. Adv Otorhinolaryngol 2005;62:7280.
6Huang, SH, Perez-Ordonez, B, Liu, FF, Waldron, J, Ringash, J, Irish, J et al. Atypical clinical behavior of p16-confirmed HPV-related oropharyngeal squamous cell carcinoma treated with radical radiotherapy. Int J Radiat Oncol Biol Phys 2012;82:276–83.
7Müller, S, Khuri, FR, Kono, SA, Beitler, JJ, Shin, DM, Saba, NF. HPV positive squamous cell carcinoma of the oropharynx. Are we observing an unusual pattern of metastases? Head Neck Pathol 2012;6:336–44.
8Haigentz, M Jr, Hartl, DM, Silver, CE, Langendijk, JA, Strojan, P, Paleri, V et al. Distant metastases from head and neck squamous cell carcinoma. Part III. Treatment. Oral Oncol 2012;48:787–93.
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The Journal of Laryngology & Otology
  • ISSN: 0022-2151
  • EISSN: 1748-5460
  • URL: /core/journals/journal-of-laryngology-and-otology
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