Impact of Smoking and Primary Tumor Subsite on Recurrence in HPV‐Associated Oropharyngeal Squamous Cell Carcinoma
| Autor: | Rex H. Lee, Jonathan R. George, Chase M. Heaton, Ivan H. El-Sayed, Patrick K. Ha, William R. Ryan, Tania Benjamin, Madeleine A. Salesky |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Oncology medicine.medical_specialty Disease Lower risk Internal medicine medicine Humans Retrospective Studies Squamous Cell Carcinoma of Head and Neck business.industry Proportional hazards model Papillomavirus Infections Smoking Head and neck cancer Hazard ratio Cancer Retrospective cohort study Middle Aged medicine.disease Primary tumor Oropharyngeal Neoplasms Otorhinolaryngology Head and Neck Neoplasms Surgery business |
| Zdroj: | Otolaryngology–Head and Neck Surgery. 166:704-711 |
| ISSN: | 1097-6817 0194-5998 |
| DOI: | 10.1177/01945998211024515 |
| Popis: | OBJECTIVE To describe risk of recurrence and recurrence characteristics between ever- and never-smoking patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV+ OPSCC) when stratified by primary tumor subsite. STUDY DESIGN Retrospective observational study. SETTING Tertiary care center. METHODS Retrospective chart review of 171 patients with HPV+ OPSCC with primary treatment between 2008 and 2019. Five-year recurrence-free survival and risk of recurrence were evaluated through Kaplan-Meier curves with log-rank test and Cox proportional hazards models, respectively. RESULTS Of 171 patients with HPV+ OPSCC, 81.9% were male, and the average age was 63.9 years. Eighty patients (46.8%) had a smoking history (average, 17.7 pack-years), including 4 current smokers. Recurrence occurred in 31 patients (18.1%), 19 of whom were ever smokers. The recurrence rate for ever smokers with primary base of tongue (BOT) cancer was 41.7%, while 5.1% of never smokers with BOT primaries had recurrence. For primary tonsillar disease, 9.1% of ever smokers had recurrence versus 19.2% of never smokers. Five-year recurrence-free survival for BOT primaries was lower in ever smokers than never smokers (P = .001) but did not differ between ever and never smokers for tonsillar primaries (P = .215). In multivariable analysis across this period, ever-smoking status was associated with higher risk of recurrence than never-smoking status in BOT primaries (adjusted hazard ratio, 7.36; 95% CI, 1.61-33.68; P = .010) but with lower risk of recurrence after tonsillar primaries (adjusted hazard ratio, 0.23; 95% CI, 0.06-0.89; P = .033). CONCLUSION Smoking may uniquely interact with tumor subsites within the oropharynx to influence recurrence risk. Understanding the association between smoking and HPV+ OPSCC recurrence could lead to personalized, evidence-based treatments to improve oncologic outcomes. |
| Databáze: | OpenAIRE |
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