Last AS, Pipkorn P, Chen S, et al. - Among patients with human papillomavirus (HPV)-related base of the tongue (BOT) oropharyngeal squamous cell carcinoma (OPSCC) undergoing transoral surgery and bilateral neck dissections, researchers studied the rate of and risk factors for occult contralateral nodal disease. For this retrospective case series, they reviewed the records of individuals with HPV-related BOT OPSCC who had transoral surgery and bilateral neck dissections from January 1, 2002, through December 31, 2018, at the tertiary care center of Washington University School of Medicine in St Louis. The sample consisted of 89 patients [the mean (SD) age was 60 (9) years]. Data reported that 15 of 70 patients with no clinical evidence of disease (21.4%) were found to have an occult contralateral nodal disease. An increased risk of contralateral disease was identified when the primary tumor crossed midline. Patients with an outcome of contralateral neck dissection that is pathologically negative may not benefit from radiotherapy to that nodal basin. In this patient population, contralateral elective neck dissection or radiotherapy is suggested.