Key points
- Patients with p16+ve OPSCC who are staged cN0 pre-treatment, and who
undergo primary surgical treatment of the neck, are required to have a
neck dissection including levels II, III and IV to avoid incomplete
surgical management of occult nodal disease.
- If patients are staged cN+ve pre-treatment, there is high positive
predictive value for the presence of pathological nodal disease at the
corresponding neck level.
- There is poor negative predictive value for the absence of nodal
disease clinically at level II.
- The nodal distribution of
HPV-specific disease is not significantly different to that found in
previous studies that have not regarded HPV (or p16) status.
- We demonstrate a sensitivity of 93% and a specificity of 83% for cN0
staging in p16+ve OPSCC