Does p16 status (HPV) influence your decision on whether to offer adjuvant chemoradiation or radiation in node positive H&N cancers?

No, p16 status should not influence the decision for initiating adjuvant therapy as p16+ patients have similar risks for failure after surgery as p16- patients without adjuvant care. Whether these patients may receive de-escalated therapy as part of a clinical trial is a separate question from whether they need adjuvant treatment.

A recent joint analysis by the Mayo Clinic Rochester, Arizona, Jacksonville, and the University of Pennsylvania looked at 53 p16+ oropharynx patients who had either intermediate or high risk factors after surgery but declined adjuvant therapy. The 3-year cumulative incidence of relapse was 26.0% (11.8% in the 37 intermediate-risk patients and 52.4% in the 16 high-risk patients.)

Given the increased sensitivity of H...