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Introduction

Despite the decline in tobacco use in the US over the past several decades, the incidence of head and neck squamous cell carcinoma (HNSCC) continues to climb. Previously considered a disease of smokers and drinkers, we are now seeing HNSCC more frequently in those who have never smoked or drank. This trend change is due, in part, to an increase in oropharyngeal squamous cell carcinoma (OPSCC) and the emerging importance of the sexually transmitted HPV virus . Young, non-smoking, sexually active men from developed countries are the patient cohort most commonly afflicted by HPV-associated HNSCC . Fortunately, HPV-associated carcinomas exhibit improved response to treatment and better survival outcomes than HPV negative tumors and tumors associated with smoking and/or drinking . The p16 protein is commonly used as a reliable surrogate for HPV infection and can be readily detected via immunohistochemical staining of pathology specimens . Patients with p16-positive tumors have improved disease specific and overall survival rates as compared to p16-negative counterparts . This success in treatment has spawned much study considering the possibility of therapy de-escalation in patients with p16-positive tumors. However, few have looked at the small subset of patients with p16-positive oropharyngeal cancer who have disease recurrence. This study compares the clinicopathologic characteristics and outcomes of recurrent p16+ and p16− oropharyngeal squamous cell carcinoma.