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Impact of active smoking on outcomes in HPV+ oropharyngeal cancer
Author(s) -
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.
Publication year - 2020
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.26001
Subject(s) - medicine , smoking cessation , cohort , retrospective cohort study , smoking history , human papillomavirus , oncology , basal cell , cohort study , pathology
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.