Beitler JJ, et al. - Since a better understanding of the metastatic risk in human papillomavirus–associated squamous cell oropharyngeal cancer is essential with regard to ongoing efforts to de-intensify therapy for these patients, researchers investigated risk factors for metastases in multivariate analysis of 547 patients from Radiation Therapy Oncology Group 0129 and 0522 with nonmetastatic oropharyngeal squamous cell cancers with a known p16 status and smoking status. The link between clinical features and distant metastases risk was evaluated during a median follow-up of 4.8 years. In patients with squamous cell cancers of the oropharynx treated definitively with concurrent chemoradiation, the factors that were identified to be related to the development of distant metastases included an age ≥ 50 years, smoking for more than 0 pack-years, N3 disease, T4 disease, and a negative p16 status.