Oropharyngeal carcinoma: a single institution study of 338 primaries with special reference to high-risk human papillomavirus-mediated carcinoma with aggressive behavior

Abstract In a retrospective review, we identified 332 patients with 338 pathologically diagnosed primary oropharyngeal carcinomas (OPC) between January 2013 and March 2020 with known p16/HPV status from a tumor registry at Northwestern Memorial Hospital. The tumors predominantly involved the palatine tonsil (51%) and the base of the tongue/lingual tonsil (38%). The most common type of cancer was non-keratinizing squamous cell carcinoma (60%), and the majority of primaries were p16 positive/HPV-mediated (86%). A cohort of p16 positive/HPV mediated OPC (27/283, 9.5%) presented with aggressive clinical behavior, including multiple distant metastases at unusual sites. Tumor size >2 cm and the presence of tumor anaplasia/multinucleation were significantly associated with an increased rate of distant metastases in p16 positive/HPV mediated cases, both in unadjusted and adjusted analyses (all P