Wittekindt et al. (2018),10 declares the failure of primary treatment in patients with HPV-negative carcinomas often leads to the development of locoregional recurrence, while primary treatment failure in patients with HPV-induced carcinomas often leads to the development of distant metastasis, however, our results showed the negative p16INK4a expression has the most frequency and lower time free of distant metastasis and recurrence. This evidence concerns the gene CDKN2A and carcinoma.