Impact on survival of tobacco smoking for cases with oropharyngeal squamous cell carcinoma and known human papillomavirus and p16-status: a multicenter retrospective study

Christian Grønhøj, Jakob Schmidt Jensen, Steffen Wagner, Christian Dehlendorff, Jeppe Friborg, Elo Andersen, Claus Wittekindt, Nora Würdemann, Shachi Jenny Sharma, Stefan Gattenlöhner, Jens Peter Klussmann, Christian von Buchwald

Abstract

Background: Human papilloma virus (HPV) and tobacco smoking are important risk factors for development of oropharyngeal squamous cell carcinoma (OPSCC).

Aims/objectives: To evaluate the impact of tobacco smoking on survival for cases with OPSCC with known HPV- and p16INK4A(p16)-status.

Materials and Methods: OPSCC cases at the University Hospital of Copenhagen, Rigshospitalet, Denmark (2000-2014) and at University Hospital of Giessen, Germany (2000-2009) were included. Survival was illustrated with Kaplan-Meier plots. The effect of smoking exposure on survival was evaluated by Cox-regression models. HPV-positivity was defined as positivity for both HPV-DNA and p16.

Results: We included 1316 OPSCC cases from 2000-2014 (48% HPV-positive). Smokers had a poorer outcome compared to non-smokers. Considering continuous smoking exposure, adding 10 pack-years of smoking increased hazard ratios irrespective of HPV-status.We observed a tendency to a greater impact on survival for cases with HPV-neg. tumours compared to cases with HPV-pos. tumours at low numbers of pack-years, yet the survival was similar at high numbers of pack-years. There was no significant difference in the impact of HPV-status on survival for non-smokers, however a highly significant difference for smokers.

Conclusions and Significance: Smoking-status and number of pack-years at time of diagnosis impact survival for cases with OPSCC independent of HPV-status.

Original languageEnglish
JournalOncotarget
Volume10
Issue number45
Pages (from-to)4655-4663
Number of pages9
ISSN1949-2553
DOIs
Publication statusPublished - 23 Jul 2019

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