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Oral Oncol. 2018 Jul;82:131-137. doi: 10.1016/j.oraloncology.2018.05.007. Epub 2018 May 26.

Smoking impact on HPV driven head and neck cancer's oncological outcomes?

Author information

1
Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France. Electronic address: haitham.mirghani@gustaveroussy.fr.
2
Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France.
3
Department of Biopathology, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France.
4
Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France.
5
Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France.

Abstract

INTRODUCTION:

HPV-driven oropharyngeal cancer (OPC) patients have a better prognosis than their HPV-negative counterparts but several studies have suggested that among HPV-positive patients those with a smoking history had worse oncological outcomes. The aim of our study is to characterize the interplay between tobacco consumption, patient and disease characteristics, and disease control.

MATERIALS AND METHODS:

All patients diagnosed with HPV-driven OPC and treated with curative intent between 2007 and 2009 and 2011-2016 at Gustave Roussy cancer center were included (n = 282). Demographic, clinical, morphological and tobacco consumption were correlated with oncologic outcomes.

RESULTS:

157 (56%) patients had a positive smoking history, including 23.8% who were smoking at the time of diagnosis and 37.6% who had a tobacco consumption exceeding 20 pack-years. In multivariate analysis, the strongest prognostic factor for survival was smoking status at cancer diagnosis, with a hazard ratio (HR) for non-smokers compared to smokers of 0.25 ([0.12, 0.50], p = 0.0001). Smoking history, either more than 20 pack-years or smoking at diagnosis, was associated with local relapse and distant relapse. There was no difference in terms of comorbidity (p = 0.32) and radiotherapy duration (p = 0.93) according to tobacco consumption.

DISCUSSION:

Smoking is frequent among patients with HPV-driven OPC and increases the risk of death and oncologic failure.

KEYWORDS:

Cancer; Human papillomavirus (HPV); Oral/oropharynx/oropharyngeal; Outcomes; Prognosis; Smoking/tobacco; Survival

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