{
  "abstract": "Background/Objectives: p16 immunohistochemistry is the standard surrogate for HPV causation in oropharyngeal squamous-cell carcinoma (OPSCC), but p16/HPV discordance is more frequent where the HPV-attributable fraction is low. We assessed the p16-positive fraction, p16/HPV-DNA discordance, and survival of OPSCC in northern Spain. Methods: Retrospective cohort of 152 consecutive OPSCC (2019–2024). HPV-DNA PCR was performed selectively in p16-positive tumours; selection was assessed with a quantitative bias analysis. Overall survival (OS) was analysed with Kaplan–Meier and Cox regression. Results: Fifty-seven tumours (37.5%) were p16-positive; these patients were younger, drank less often, and more often had tonsil/base-of-tongue primaries. HPV-DNA was negative in six of twenty-eight tested p16-positive tumours (discordance 21.4%; 95% CI 10.2–39.5). Testing favoured never-drinkers, and sensitivity analyses for selective testing gave estimates of 16–36%. Two-year OS was 86.3% for p16-positive and 53.9% for p16-negative disease. p16 negativity was associated with death after adjustment for stage, alcohol, and age (HR 3.00; 95% CI 1.44–6.26), but the association was attenuated in curatively treated patients (HR 2.30; 95% CI 0.99–5.33). Conclusions: In this region, about one in three OPSCC is p16-positive and one in five tested p16-positive tumours lacks HPV-DNA. Systematic dual p16/HPV testing is advisable before p16 status guides staging or de-escalation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Otorhinolaryngology—Head and Neck Surgery, Hospital Universitario Donostia, Paseo Dr. Begiristain 1, 20014 San Sebastián, Gipuzkoa, Spain",
    "Department of Medical Oncology, Hospital Universitario Donostia, Paseo Dr. Begiristain 1, 20014 San Sebastián, Gipuzkoa, Spain",
    "Department of Radiation Oncology, Hospital Universitario Donostia, Paseo Dr. Begiristain 1, 20014 San Sebastián, Gipuzkoa, Spain",
    "Department of Pathology, Hospital Universitario Donostia, Paseo Dr. Begiristain 1, 20014 San Sebastián, Gipuzkoa, Spain"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Carlos M. Chiesa-Estomba"
    },
    {
      "affs": [
        0
      ],
      "name": "Maider Andueza-Guembre",
      "orcid": "0009-0000-6942-1848"
    },
    {
      "affs": [
        0
      ],
      "name": "Paulina Droppelman-Álvarez"
    },
    {
      "affs": [
        1
      ],
      "name": "Laura Basterretxea-Badiola",
      "orcid": "0000-0001-8450-713X"
    },
    {
      "affs": [
        2
      ],
      "name": "Leyre González-Vallejo",
      "orcid": "0000-0002-0788-4887"
    },
    {
      "affs": [
        3
      ],
      "name": "Pablo Aguirre-Echeverria"
    },
    {
      "affs": [
        0
      ],
      "name": "Ekhiñe Larruscain-Sarasola"
    },
    {
      "affs": [
        0
      ],
      "name": "José Ángel González-García"
    },
    {
      "affs": [
        0
      ],
      "name": "Jon Alexander Sistiaga-Suárez",
      "orcid": "0000-0001-6668-3156"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/de7xgke9a9wcb.bib",
  "cited_by": 0,
  "doi": "10.3390/cancers18213433",
  "fulltext_url": null,
  "id": "de7xgke9a9wcb",
  "issns": [
    "2072-6694"
  ],
  "landing_url": "https://www.mdpi.com/2072-6694/18/21/3433",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2733|Head and Neck Cancer Studies"
    ]
  ],
  "openalex": "W7223689120",
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/de7xgke9a9wcb.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:58Z",
      "native_id": "10.3390/cancers18213433",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6694/18/21/3433"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2072-6694",
      "subfield": "oncology"
    }
  ],
  "title": "Clinical Profile and Survival of Oropharyngeal Squamous-Cell Carcinoma in a Region of Northern Spain with a Low HPV-Attributable Fraction: A Retrospective Cohort Study",
  "title_text": "Clinical Profile and Survival of Oropharyngeal Squamous-Cell Carcinoma in a Region of Northern Spain with a Low HPV-Attributable Fraction: A Retrospective Cohort Study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:58Z",
  "url": "https://research.draconitic.com/paper/de7xgke9a9wcb",
  "venue": "Cancers",
  "versions": []
}