A 55-year-old male with HPV-negative oropharyngeal squamous cell carcinoma staged as T2N1M0 is being counseled about prognosis. Compared to HPV-positive oropharyngeal cancer of the same stage, HPV-negative disease is associated with:

• A Better overall survival and higher response rates to chemoradiation
• B Worse overall survival and higher risk of distant metastasis ✓
• C Similar survival outcomes with identical treatment protocols
• D Better local control but higher rates of second primary tumors

Explanation

HPV-negative oropharyngeal squamous cell carcinoma carries a significantly worse prognosis compared to HPV-positive disease, with lower overall survival and higher rates of distant metastasis. HPV-positive tumors are more responsive to chemoradiation and have better outcomes. This distinction is now incorporated into AJCC 8th edition staging, with HPV-positive and HPV-negative oropharyngeal cancers having separate staging systems.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

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Written and medically reviewed by the StethoPrep medical team.