Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation

Alexis J. Platek; Vijayvel Jayaprakash; Mihai Merzianu; Mary E. Platek; David M. Cohan; Wesley L. Hicks; Sathiya P. Marimuthu; Timothy B. Winslow; Vishal Gupta; Hassan Arshad; Moni A. Kuriakose; Shiva Dibaj; James R. Marshall; Mary E. Reid; Graham W. Warren; Anurag K. Singh

doi:10.1002/lary.26083

Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation

Alexis J. Platek, Vijayvel Jayaprakash, Mihai Merzianu, Mary E. Platek, David M. Cohan, Wesley L. Hicks, Sathiya P. Marimuthu, Timothy B. Winslow, Vishal Gupta, Hassan Arshad, Moni A. Kuriakose, Shiva Dibaj, James R. Marshall, Mary E. Reid, Graham W. Warren, Anurag K. Singh

Research output: Contribution to journal › Article › peer-review

42 Scopus citations

Abstract

Objectives/Hypothesis: The effect of smoking and human papillomavirus (HPV) on overall survival (OS) of oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing concurrent chemotherapy (CCRT) remains unclear. Study Design: Retrospective review. Methods: Clinical characteristics of OPSCC patients treated between 2008 and 2015 with CCRT were abstracted from medical records. OS curves and multivariate cox proportional hazard ratios (HRs) were examined. Results: Of 120 evaluable patients, 71% had HPV⁺ tumors. Median follow-up duration for the entire cohort was 41.5 months (range = 6–88 months). HPV⁺ current smokers experienced significantly worse 5-year OS (73% alive vs. 36% alive, P =.01) and there was a similar trend in HPV⁻ current smokers (66% alive vs. 31% alive, P =.28) compared to former/never smokers undergoing CCRT. In a multivariate cox proportional hazard model adjusted for age, gender, and overall tumor stage, HPV⁺ current smokers experienced nearly a fourfold increase in overall mortality in comparison to HPV⁺ never/former smokers (HR = 3.68, 95% CI = 1.35-10.0). Similarly, current smokers with HPV⁻ tumors (HR = 6.80, 95% CI = 1.11-41.67) had increased mortality compared to never/former smokers. Conclusions: Current smoking is associated with poor prognosis, independent of HPV status, in CCRT-treated OPSCC patients. Current smoking produced an approximately four- to sevenfold increase in risk of mortality for HPV⁺ and HPV⁻ patients, respectively. Regardless of pack years and HPV status, efforts should be made to achieve smoking cessation before CCRT. Level of Evidence: 4. Laryngoscope, 126:2733–2738, 2016.

Original language	English
Pages (from-to)	2733-2738
Number of pages	6
Journal	Laryngoscope
Volume	126
Issue number	12
DOIs	https://doi.org/10.1002/lary.26083
State	Published - 1 Dec 2016
Externally published	Yes

Keywords

Tobacco
base of tongue
human papillomavirus
nicotine
squamous cell cancer of the head and neck

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10.1002/lary.26083

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Platek, A. J., Jayaprakash, V., Merzianu, M., Platek, M. E., Cohan, D. M., Hicks, W. L., Marimuthu, S. P., Winslow, T. B., Gupta, V., Arshad, H., Kuriakose, M. A., Dibaj, S., Marshall, J. R., Reid, M. E., Warren, G. W., & Singh, A. K. (2016). Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation. Laryngoscope, 126(12), 2733-2738. https://doi.org/10.1002/lary.26083

@article{e9a3ade798234d6fa790dedda5f11fc0,

title = "Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation",

abstract = "Objectives/Hypothesis: The effect of smoking and human papillomavirus (HPV) on overall survival (OS) of oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing concurrent chemotherapy (CCRT) remains unclear. Study Design: Retrospective review. Methods: Clinical characteristics of OPSCC patients treated between 2008 and 2015 with CCRT were abstracted from medical records. OS curves and multivariate cox proportional hazard ratios (HRs) were examined. Results: Of 120 evaluable patients, 71% had HPV+ tumors. Median follow-up duration for the entire cohort was 41.5 months (range = 6–88 months). HPV+ current smokers experienced significantly worse 5-year OS (73% alive vs. 36% alive, P =.01) and there was a similar trend in HPV− current smokers (66% alive vs. 31% alive, P =.28) compared to former/never smokers undergoing CCRT. In a multivariate cox proportional hazard model adjusted for age, gender, and overall tumor stage, HPV+ current smokers experienced nearly a fourfold increase in overall mortality in comparison to HPV+ never/former smokers (HR = 3.68, 95% CI = 1.35-10.0). Similarly, current smokers with HPV− tumors (HR = 6.80, 95% CI = 1.11-41.67) had increased mortality compared to never/former smokers. Conclusions: Current smoking is associated with poor prognosis, independent of HPV status, in CCRT-treated OPSCC patients. Current smoking produced an approximately four- to sevenfold increase in risk of mortality for HPV+ and HPV− patients, respectively. Regardless of pack years and HPV status, efforts should be made to achieve smoking cessation before CCRT. Level of Evidence: 4. Laryngoscope, 126:2733–2738, 2016.",

keywords = "Tobacco, base of tongue, human papillomavirus, nicotine, squamous cell cancer of the head and neck",

author = "Platek, {Alexis J.} and Vijayvel Jayaprakash and Mihai Merzianu and Platek, {Mary E.} and Cohan, {David M.} and Hicks, {Wesley L.} and Marimuthu, {Sathiya P.} and Winslow, {Timothy B.} and Vishal Gupta and Hassan Arshad and Kuriakose, {Moni A.} and Shiva Dibaj and Marshall, {James R.} and Reid, {Mary E.} and Warren, {Graham W.} and Singh, {Anurag K.}",

note = "Publisher Copyright: {\textcopyright} 2016 The American Laryngological, Rhinological and Otological Society, Inc.",

year = "2016",

month = dec,

day = "1",

doi = "10.1002/lary.26083",

language = "English",

volume = "126",

pages = "2733--2738",

journal = "Laryngoscope",

issn = "0023-852X",

publisher = "Wiley-Blackwell",

number = "12",

}

Platek, AJ, Jayaprakash, V, Merzianu, M, Platek, ME, Cohan, DM, Hicks, WL, Marimuthu, SP, Winslow, TB, Gupta, V, Arshad, H, Kuriakose, MA, Dibaj, S, Marshall, JR, Reid, ME, Warren, GW & Singh, AK 2016, 'Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation', Laryngoscope, vol. 126, no. 12, pp. 2733-2738. https://doi.org/10.1002/lary.26083

TY - JOUR

T1 - Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation

AU - Platek, Alexis J.

AU - Jayaprakash, Vijayvel

AU - Merzianu, Mihai

AU - Platek, Mary E.

AU - Cohan, David M.

AU - Hicks, Wesley L.

AU - Marimuthu, Sathiya P.

AU - Winslow, Timothy B.

AU - Gupta, Vishal

AU - Arshad, Hassan

AU - Kuriakose, Moni A.

AU - Dibaj, Shiva

AU - Marshall, James R.

AU - Reid, Mary E.

AU - Warren, Graham W.

AU - Singh, Anurag K.

PY - 2016/12/1

Y1 - 2016/12/1

N2 - Objectives/Hypothesis: The effect of smoking and human papillomavirus (HPV) on overall survival (OS) of oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing concurrent chemotherapy (CCRT) remains unclear. Study Design: Retrospective review. Methods: Clinical characteristics of OPSCC patients treated between 2008 and 2015 with CCRT were abstracted from medical records. OS curves and multivariate cox proportional hazard ratios (HRs) were examined. Results: Of 120 evaluable patients, 71% had HPV+ tumors. Median follow-up duration for the entire cohort was 41.5 months (range = 6–88 months). HPV+ current smokers experienced significantly worse 5-year OS (73% alive vs. 36% alive, P =.01) and there was a similar trend in HPV− current smokers (66% alive vs. 31% alive, P =.28) compared to former/never smokers undergoing CCRT. In a multivariate cox proportional hazard model adjusted for age, gender, and overall tumor stage, HPV+ current smokers experienced nearly a fourfold increase in overall mortality in comparison to HPV+ never/former smokers (HR = 3.68, 95% CI = 1.35-10.0). Similarly, current smokers with HPV− tumors (HR = 6.80, 95% CI = 1.11-41.67) had increased mortality compared to never/former smokers. Conclusions: Current smoking is associated with poor prognosis, independent of HPV status, in CCRT-treated OPSCC patients. Current smoking produced an approximately four- to sevenfold increase in risk of mortality for HPV+ and HPV− patients, respectively. Regardless of pack years and HPV status, efforts should be made to achieve smoking cessation before CCRT. Level of Evidence: 4. Laryngoscope, 126:2733–2738, 2016.

AB - Objectives/Hypothesis: The effect of smoking and human papillomavirus (HPV) on overall survival (OS) of oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing concurrent chemotherapy (CCRT) remains unclear. Study Design: Retrospective review. Methods: Clinical characteristics of OPSCC patients treated between 2008 and 2015 with CCRT were abstracted from medical records. OS curves and multivariate cox proportional hazard ratios (HRs) were examined. Results: Of 120 evaluable patients, 71% had HPV+ tumors. Median follow-up duration for the entire cohort was 41.5 months (range = 6–88 months). HPV+ current smokers experienced significantly worse 5-year OS (73% alive vs. 36% alive, P =.01) and there was a similar trend in HPV− current smokers (66% alive vs. 31% alive, P =.28) compared to former/never smokers undergoing CCRT. In a multivariate cox proportional hazard model adjusted for age, gender, and overall tumor stage, HPV+ current smokers experienced nearly a fourfold increase in overall mortality in comparison to HPV+ never/former smokers (HR = 3.68, 95% CI = 1.35-10.0). Similarly, current smokers with HPV− tumors (HR = 6.80, 95% CI = 1.11-41.67) had increased mortality compared to never/former smokers. Conclusions: Current smoking is associated with poor prognosis, independent of HPV status, in CCRT-treated OPSCC patients. Current smoking produced an approximately four- to sevenfold increase in risk of mortality for HPV+ and HPV− patients, respectively. Regardless of pack years and HPV status, efforts should be made to achieve smoking cessation before CCRT. Level of Evidence: 4. Laryngoscope, 126:2733–2738, 2016.

KW - Tobacco

KW - base of tongue

KW - human papillomavirus

KW - nicotine

KW - squamous cell cancer of the head and neck

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U2 - 10.1002/lary.26083

DO - 10.1002/lary.26083

M3 - Article

C2 - 27346612

AN - SCOPUS:84978418239

SN - 0023-852X

VL - 126

SP - 2733

EP - 2738

JO - Laryngoscope

JF - Laryngoscope

IS - 12

ER -

Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation

Abstract

Keywords

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