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Head Neck. 2016 Dec;38(12):1810-1820. doi: 10.1002/hed.24515. Epub 2016 Jul 19.

Cigarette use, comorbidities, and prognosis in a prospective head and neck squamous cell carcinoma population.

Author information

1
Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
2
Center for Cancer Biostatistics, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan.
3
Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.

Abstract

BACKGROUND:

To better understand the associations between a history of tobacco use and survival outcomes, cigarette use was prospectively surveyed in 687 previously untreated patients with cancer of the oral cavity (n = 271), oropharynx (n = 257), larynx (n = 135), or hypopharynx (n = 24).

METHODS:

Kaplan-Meier and Cox models explored the associations of tobacco use intensity (packs/day), duration (years of use), and timing before diagnosis with overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS).

RESULTS:

Cigarette use duration, timing, and intensity were significant predictors for all outcomes in univariate analysis. Never smoking and pack-years were not significantly associated with outcomes after adjustment for prognostic factors, such as stage, comorbidities, and human papillomavirus (HPV) status, which were strongly associated with clinical outcomes.

CONCLUSION:

The findings confirm the association between smoking history and survival and the importance of clinical variables in evaluating smoking as a prognostic factor. Timing, intensity, and duration of cigarette use should be considered with other prognostic factors when considering risk stratification for treatment planning. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1810-1820, 2016.

KEYWORDS:

comorbidities; duration; epidemiology; head and neck cancer; intensity; recurrence; survival; tobacco

PMID:
27432208
PMCID:
PMC5391974
DOI:
10.1002/hed.24515
[Indexed for MEDLINE]
Free PMC Article

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