There is little doubt anymore that certain HPVs are associated with a subset of oropharyngeal cancers. It is also likely that they are the cause of these cancers since the patients generally do not show excessive alcohol consumption or a history of smoking, nor other etiological factors that may associate with HNSCC/OSCC.

Furthermore, HPV-positive oropharyngeal SCCs show several common features ranging from histology to molecular markers (undifferentiated, high p16, low cyclin D1, rarely p53 mutated, RB1 low or absent, very aggressive growth and can have distant metastases...). 

Taken all this together, HPV-positive OSCCs with the above features are a group of their own: this is not trivial since these tumors tend to be less aneuploid and and respond very well to conventional radio-therapy. Their treatment therefore could be in theory be adjusted: I personally think they could skip radiation therapy (which may have more long-lasting negative side effects; Otolaryngol Head Neck Surg. 2015 Jun 29. 

HPV-Positive Oropharyngeal Carcinoma: A Systematic Review of Treatment and Prognosis. Wang MB, Liu IY, Gornbein JA, Nguyen CT; similarly HPV-positive skin cancer does also not benefit from radiation therapy: J Cutan Med Surg. 2015 Jul;19(4):416-21. doi: 10.1177/1203475415576859. Epub 2015 Mar 18.

Deleterious Effect of Radiation Therapy on Epidermodysplasia Verruciformis Patients.

de Oliveira WR1, da Cruz Silva LL2, Festa Neto C1, Tyring S3.). In contrast to many clinicians, I think chemo alone may do the "trick" for these patients. But this is just an educated guess with the side-effects in mind. I am sure not many clinicians may agree with this judgment. But the literature seems to go against radiation therapy for these patients (HPV-Positive Oropharyngeal Carcinoma: A Systematic Review of Treatment and Prognosis.).

So, these HPV-positive HNSCCs of the Waldeyer's tonsillar ring are special in their molecular profile, their histology, the personal history of the patient (smoking, alcohol) and their favorable response toward conventional therapy despite aggressive growth and high level of metastasis. These tumors should be put in their own category and treated differently from the "classical" HNSCCs.

unfortunately many studies done in the past pointed to the presence of the virus in tumors. Today we know that this is not a sufficient factor to determine that the virus is the causative agent. Molecular tests as mRNA are very important to establish a secure link between the virus and the tumor

Immunohistochemistry-- is this the best and most definitive confirmation for the HPV in

HNSCQs???

I don't think there are really good antibodies to detect HPV protein on tissue sections. Most tests are DNA and RNA based. There is an indirect IHC assay, the detection of p16 (CDKN2A). But detection of p16 is variable, depends on tools and interpretation skills etc., and some doubt it is a good indicator (Oral Oncol. 2013 Oct;49(10):e33-7. doi: 10.1016/j.oraloncology.2013.07.014. Epub 2013 Aug 17.

Identification of clinically relevant HPV-related HNSCC: in p16 should we trust?

Wasylyk B1, Abecassis J, Jung AC.). I think, it depends on how well you do your assays. Since HPV-driven HNSCCs have frequently are very distinct histologically, high proliferation rate, loss of RB1 and cyclin D1 expression, one can combine these markers with a "simple" HPV assay (a DNA assay rather than an E6/E7 mRNA assay that might be tricky on FFPE tissue material). Then combined with p16 IHC, I am pretty sure one can make a very strong statement about the contribution of HPV to the individual tumor and "declare" it HPV-driven/induced/maintained or not.

A recent review summarizes the field as following: "The optimal testing method for the diagnosis of biologically and clinically relevant HPV infection in the oropharynx has not been identified yet. Mirghani et al. [18] reviews the existing framework of techniques and describes their limitations. Detection of E6 and E7 mRNA expression represents the “gold standard” for the diagnosis of an HPV-positive head and neck cancer but it is often difficult in formalin fixed paraffin embedded tissue. p16 protein detection by immunohistochemistry is a reliable surrogate for a clinically relevant HPV infection in oropharynx and is being used for patient stratification in clinical trials. Compared to p16, detection of HR-HPV DNA by in situ hybridization is more specific but less sensitive. As the authors indicate, this is a rapidly evolving field." (Oral Oncol. 2014 May;50(5):353-5. doi: 10.1016/j.oraloncology.2014.03.010. HPV and head and neck cancers: state-of-the-science. Fakhry C1, Psyrri A2, Chaturvedhi A3.). Similarly, the ARCAGE study summary comes to the conclusion that certain markers and serological analysis for anti-HPV antibodies are good indicators (J Natl Cancer Inst. 2013 Apr 17;105(8):536-45. doi: 10.1093/jnci/djt053. Epub 2013 Mar 16.

Human papillomavirus infections and upper aero-digestive tract cancers: the ARCAGE study. Anantharaman D1, Gheit T, Waterboer T, Abedi-Ardekani B, Carreira C, McKay-Chopin S, Gaborieau V, Marron M, Lagiou P, Ahrens W, Holcátová I, Merletti F, Kjaerheim K, Talamini R, Simonato L, Castellsague X, Macfarlane TV, Biggs AM, Thakker N, Znaor A, Thomson P, Canova C, Conway DI, Healy CM, Tommasino M, Pawlita M, Brennan P.). 

A novel HPV detection method was just described (Sci Rep. 2015 Sep 3;5:13686. doi: 10.1038/srep13686. Establishment of immunoassay for detecting HPV16 E6 and E7 RNA.Ding S1,2, Qian SY3, Zhang Y1,2, Wu W4, Lu G5, Lu Y1,2, Feng X1,2, Li L6, Shen P1,2.)

hello Ma'am, i know this question was asked 4 years ago. but just wanted to know, did you get any registry or database of HPV associated OSCC?