{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T10:24:06Z","timestamp":1781346246987,"version":"3.54.1"},"reference-count":22,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T00:00:00Z","timestamp":1679356800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100019266","name":"Korea Medical Device Development Fund","doi-asserted-by":"publisher","award":["202011D15"],"award-info":[{"award-number":["202011D15"]}],"id":[{"id":"10.13039\/100019266","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Human papilloma virus (HPV)-related tonsil cancer is associated with favorable outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>The purpose of this study was to define factors affecting distant metastasis in patients with surgically treated HPV-positive tonsil cancer.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>The present study enrolled 76 patients diagnosed with HPV-positive tonsil cancer who underwent primary surgery between January 2010 and December 2021.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>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\u2013149.863, <jats:italic>p<\/jats:italic> = 0.003) and margin involvement (OR: 5.96, 95% CI: 1.33\u201326.76, <jats:italic>p<\/jats:italic> = 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\u201347.016; <jats:italic>p<\/jats:italic> &lt; 0.001) and margin involvement (HR: 6.243; 95% CI: 1.681\u201323.191; <jats:italic>p<\/jats:italic> = 0.006) were significant factors associated with the five-year disease-specific survival.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0283368","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T17:28:17Z","timestamp":1679419697000},"page":"e0283368","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":4,"title":["Predictive factors of distant metastasis in surgically treated HPV-positive tonsil 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