{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:17:34Z","timestamp":1787984254618,"version":"build-2784847793"},"reference-count":46,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The AJCC 8th edition distinguishes p16\u2010positive oropharyngeal head and neck carcinoma of unknown primary (HNCUP) due to its superior prognosis. However, standardized radiation volume guidelines are lacking. This study evaluates the safety of p16\u2010guided mucosal volume reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review of 126 HNCUP patients (2009\u20132023) was conducted. p16\u2010negative patients received comprehensive mucosal and laryngeal irradiation; p16\u2010positive patients received risk\u2010adapted, reduced\u2010volume radiation limited to the ipsilateral naso\u2010 and oropharyngeal mucosa and elective nodal regions. Acute and late toxicities were reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort included 97 p16\u2010positive and 29 p16\u2010negative patients (median follow\u2010up 38\u2009months). Five\u2010year overall survival was 90.0% versus 69.2% for p16\u2010positive and p16\u2010negative patients. All mucosal emergences and neck recurrences occurred within the radiation fields. Acute grade 3 toxicities were comparable between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>p16\u2010guided mucosal volume reduction in HNCUP appears oncologically safe, without compromising disease control or survival, supporting radiotherapy volume de\u2010intensification for p16\u2010positive disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.70431","type":"journal-article","created":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T06:04:41Z","timestamp":1787983481000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Head and Neck Lymph Node Metastases From Cancer of Unknown Primary: Outcomes From p16\u2010Guided Mucosal Radiotherapy"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0848-1796","authenticated-orcid":false,"given":"Philippe","family":"Harris","sequence":"first","affiliation":[{"name":"Faculty of Medicine Universit\u00e9 de Montr\u00e9al  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhiya\u2010Eddine","family":"Mabrouki","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Sciences McGill University  Montr\u00e9al Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix\u2010Phuc","family":"Nguyen\u2010Tan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM), Universit\u00e9 de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edith","family":"Filion","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM), Universit\u00e9 de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Ballivy","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM), Universit\u00e9 de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8887-843X","authenticated-orcid":false,"given":"Brian","family":"O'Sullivan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM), Universit\u00e9 de Montr\u00e9al  Montreal Quebec Canada"},{"name":"Department of Radiation Oncology, Princess Margaret Cancer Center University of Toronto  Toronto Ontario 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Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9382-7597","authenticated-orcid":false,"given":"Antoine","family":"Desilets","sequence":"additional","affiliation":[{"name":"Department of Medicine, Service of Hemato\u2010Oncology Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM), Universit\u00e9 de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre Pellan","family":"Cheng","sequence":"additional","affiliation":[{"name":"Centre de Recherche du Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CRCHUM), Universit\u00e9 de Montr\u00e9al  Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Doucet","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Centre Hospitalier de l'Universit\u00e9 de Montr\u00e9al (CHUM), Universit\u00e9 de 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