Premium
Cigarette use, comorbidities, and prognosis in a prospective head and neck squamous cell carcinoma population
Author(s) -
Peterson Lisa A.,
Bellile Emily L.,
Wolf Gregory T.,
Virani Shama,
Shuman Andrew G.,
Taylor Jeremy M. G.,
Rozek Laura S.
Publication year - 2016
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24515
Subject(s) - medicine , head and neck cancer , oncology , proportional hazards model , multivariate analysis , univariate analysis , prospective cohort study , population , stage (stratigraphy) , cancer , paleontology , environmental health , biology
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