Impact of active smoking on outcomes in HPV+ oropharyngeal cancer. Issue 2 (26th November 2019)

• Record Type: Journal Article
• Authors: Xiao, Roy; Pham, Yvonne; Ward, Matthew C.; Houston, Narcissa; Reddy, Chandana A.; Joshi, Nikhil P.; Greskovich, John F.; Woody, Neil M.; Chute, Deborah J.; Lamarre, Eric D.; Prendes, Brandon L.; Lorenz, Robert R.; Scharpf, Joseph; Burkey, Brian B.; Geiger, Jessica L.; Adelstein, David J.; Koyfman, Shlomo A.
• Is Part Of: Head & neck. Volume 42:Issue 2(2020)
• Page Start: 269
• Page End: 280
• Publication Date: 2019-11-26
• Subjects: human papillomavirus -- oropharyngeal cancer -- overall survival -- pack‐years -- smoking status; Head -- Diseases -- Periodicals; Neck -- Diseases -- Periodicals; Head -- Periodicals; Neck -- Periodicals; Face -- Periodicals; 617.51059
• DOI: 10.1002/hed.26001
• Languages: English
• ISSNs: 1043-3074

Abstract

Abstract: Background: The role of smoking among patients with human papillomavirus (HPV)‐positive oropharyngeal squamous cell carcinoma (OPSCC) is unclear. Methods: A retrospective cohort study of patients with HPV(+) OPSCC from 2001 to 2015 at a tertiary‐care institution was conducted. The primary outcome was overall survival (OS). Results: Among 484 included patients, 94 (19.4%) were active smokers, 226 (46.7%) were former smokers, and 164 (33.9%) never smoked. Among active smokers, 82 patients (87.2%) had a ≥10 pack‐year and 69 (73.4%) had a ≥20 pack‐year smoking history. After adjusting for covariates, active smoking was a significant predictor of inferior OS (HR 2.28, P < .001) and PFS (HR 2.26, P < .001). When including pack‐years as the covariate, ≥20 pack‐years predicted a decreased effect‐size for inferior OS and PFS. Conclusions: For patients with HPV(+) OPSCC, active smoking at diagnosis is the most powerful covariate capturing smoking history to predict OS and PFS.