Smoking impact on HPV driven head and neck cancer's oncological outcomes?. (July 2018)

• Record Type: Journal Article
• Authors: Mirghani, Haitham; Leroy, Charlotte; Chekourry, Younes; Casiraghi, Odile; Aupérin, Anne; Tao, Yungan; Nguyen, France; Caroline, Even; Breuskin, Ingrid; Plana, Antoine Moya; Hartl, Dana; Janot, François; Temam, Stéphane; Gorphe, Philippe; Blanchard, Pierre
• Is Part Of: Oral oncology. Volume 82(2018)
• Page Start: 131
• Page End: 137
• Publication Date: 2018-07
• Subjects: Human papillomavirus (HPV) -- Smoking/tobacco -- Cancer -- Oral/oropharynx/oropharyngeal -- Prognosis -- Outcomes -- Survival; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2018.05.007
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: HPV-driven OPC have overall a good prognosis. Smoking status at cancer diagnosis is the strongest prognostic factor for survival. Half of HPV-positive patients have a smoking history and almost 35% smoked more than 20 PY. Smoking cessation remains a priority in head and neck oncology even for HPV-positve patients. 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.