Haitham Mirghani1, Charlotte Leroy2, Younes Chekourry2, Odile Casiraghi3, Anne Aupérin4, Yungan Tao5, France Nguyen5, Even Caroline2, Ingrid Breuskin2, Antoine Moya Plana2, Dana Hartl2, François Janot2, Stéphane Temam2, Philippe Gorphe2, Pierre Blanchard5. 1. Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France. Electronic address: haitham.mirghani@gustaveroussy.fr. 2. Department of Head and Neck Oncology, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France. 3. Department of Biopathology, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France. 4. Department of Biostatistics and Epidemiology, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France. 5. Department of Radiation Oncology, Gustave Roussy Cancer Campus, 114 rue Edouard Vaillant, Villejuif, France.
Abstract
INTRODUCTION: HPV-driven oropharyngeal cancer (OPC) patients have a better prognosis than their HPV-negative counterparts but several studies have suggested that among HPV-positive patients those with a smoking history had worse oncological outcomes. The aim of our study is to characterize the interplay between tobacco consumption, patient and disease characteristics, and disease control. MATERIALS AND METHODS: All patients diagnosed with HPV-driven OPC and treated with curative intent between 2007 and 2009 and 2011-2016 at Gustave Roussy cancer center were included (n = 282). Demographic, clinical, morphological and tobacco consumption were correlated with oncologic outcomes. RESULTS: 157 (56%) patients had a positive smoking history, including 23.8% who were smoking at the time of diagnosis and 37.6% who had a tobacco consumption exceeding 20 pack-years. In multivariate analysis, the strongest prognostic factor for survival was smoking status at cancer diagnosis, with a hazard ratio (HR) for non-smokers compared to smokers of 0.25 ([0.12, 0.50], p = 0.0001). Smoking history, either more than 20 pack-years or smoking at diagnosis, was associated with local relapse and distant relapse. There was no difference in terms of comorbidity (p = 0.32) and radiotherapy duration (p = 0.93) according to tobacco consumption. DISCUSSION: Smoking is frequent among patients with HPV-driven OPC and increases the risk of death and oncologic failure.
INTRODUCTION:HPV-driven oropharyngeal cancer (OPC) patients have a better prognosis than their HPV-negative counterparts but several studies have suggested that among HPV-positive patients those with a smoking history had worse oncological outcomes. The aim of our study is to characterize the interplay between tobacco consumption, patient and disease characteristics, and disease control. MATERIALS AND METHODS: All patients diagnosed with HPV-driven OPC and treated with curative intent between 2007 and 2009 and 2011-2016 at Gustave Roussy cancer center were included (n = 282). Demographic, clinical, morphological and tobacco consumption were correlated with oncologic outcomes. RESULTS: 157 (56%) patients had a positive smoking history, including 23.8% who were smoking at the time of diagnosis and 37.6% who had a tobacco consumption exceeding 20 pack-years. In multivariate analysis, the strongest prognostic factor for survival was smoking status at cancer diagnosis, with a hazard ratio (HR) for non-smokers compared to smokers of 0.25 ([0.12, 0.50], p = 0.0001). Smoking history, either more than 20 pack-years or smoking at diagnosis, was associated with local relapse and distant relapse. There was no difference in terms of comorbidity (p = 0.32) and radiotherapy duration (p = 0.93) according to tobacco consumption. DISCUSSION: Smoking is frequent among patients with HPV-driven OPC and increases the risk of death and oncologic failure.
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