The role of human papilloma virus and p16 in occult primary of the head and neck: A comprehensive review of the literature

Cancer of unknown primary of the head and neck is a challenging entity for the oncologist. The role of human papilloma virus/p16 in carcinogenesis and in prognosis is well established in certain HNSCC especially in that of the oropharynx. In the case of occult primary of the head and neck the role of HPV/p16 positivity is not well defined regarding prognosis and localization of the primary. An independent review of PubMed and ScienceDirect database was performed up to May 2014 using combinations of terms such as ''occult primary of the head and neck'', ''CUP of the head and neck'' ''metastatic cervical squamous cell carcinoma of unknown primary'', ''HPV'' and ''HPV and head and neck cancer''. Literature review shows a strong association between HPV/p16 positivity and primary location in the oropharynx in patients with CUP of the head and neck as well as a better clinical outcome. HPV positivity and p16 overexpression could be used as surrogate markers in the search of the primary site of patients with CUP of the head and neck therefore maybe guiding treatment decisions. (C) 2014 Elsevier Ltd. All rights reserved.