Predictive factors of distant metastasis in surgically treated HPV-positive tonsil cancer

Hyun-Il Shin; Kwang-Jae Cho; Min-Sik Kim; Young-Hoon Joo

doi:10.1371/journal.pone.0283368

Predictive factors of distant metastasis in surgically treated HPV-positive tonsil cancer

PLoS One. 2023 Mar 21;18(3):e0283368. doi: 10.1371/journal.pone.0283368. eCollection 2023.

Authors

Hyun-Il Shin¹, Kwang-Jae Cho¹, Min-Sik Kim¹, Young-Hoon Joo¹

Affiliation

¹ Department of Otorhinolaryngology, The Catholic University of Korea, College of Medicine, Seoul, Korea.

Abstract

Background: Human papilloma virus (HPV)-related tonsil cancer is associated with favorable outcomes.

Objective: The purpose of this study was to define factors affecting distant metastasis in patients with surgically treated HPV-positive tonsil cancer.

Methods: The present study enrolled 76 patients diagnosed with HPV-positive tonsil cancer who underwent primary surgery between January 2010 and December 2021.

Results: Twelve (15.7%) patients experienced a distant failure with a median follow-up time of 43 months. Sites of distant metastasis included the lung (n = 10), liver (n = 1), and brain (n = 1). Upon multivariate analysis, an advanced T stage (odds ratio [OR]: 13.94, 95% confidence interval [CI]: 1.29-149.863, p = 0.003) and margin involvement (OR: 5.96, 95% CI: 1.33-26.76, p = 0.02) were independent predictors of distant metastases. The five-year disease-specific survival for the entire cohort was 85%. The multivariate analysis confirmed that distant metastasis (hazard ratio [HR]: 12.688, 95% CI: 3.424-47.016; p < 0.001) and margin involvement (HR: 6.243; 95% CI: 1.681-23.191; p = 0.006) were significant factors associated with the five-year disease-specific survival.

Conclusion: HPV-positive tonsil cancer patients with an advanced T stage and a positive surgical margin have a substantial risk of distant metastases. Distant metastasis and margin involvement are factors that affect their survival.

Copyright: © 2023 Shin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Humans
Multivariate Analysis
Neoplasm Metastasis
Neoplasm Recurrence, Local / pathology
Neoplasm Staging
Papillomavirus Infections*
Prognosis
Proportional Hazards Models
Retrospective Studies
Tonsillar Neoplasms* / pathology
Tonsillar Neoplasms* / surgery

Grants and funding

This work was supported by the Korea Medical Device Development Fund grant funded by the Korea government (the Ministry of Science and ICT, the Ministry of Trade, Industry and Energy, the Ministry of Health & Welfare, the Ministry of Food and Drug Safety) (Project Number: 202011D15). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.