Adverse effect of smoking on prognosis in human papillomavirus–associated oropharyngeal carcinoma

Liskamp, Carmen P.; Janssens, Geert O.; Bussink, Johan; Melchers, Willem J. G.; Kaanders, J.H.A.M.; Verhoef, C.

doi:10.1002/hed.24516

Cited by 21 publications

(24 citation statements)

References 40 publications

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“…Several studies have found smoking to be significantly associated with worse prognosis among HPV‐positive OPSCC patients, but this association was not detected in our HPV‐positive patients. This may be due to the retrospective nature of this study, as medical records may not have fully captured tobacco exposure.…”

Section: Discussioncontrasting

confidence: 84%

“…Few studies have focused on prognostic factors for survival after stratification for HPV status in OPSCCs. Initial studies suggest that among patients with HPV‐positive OPSCCs, older age, smoking, and higher American Joint Committee on Cancer (AJCC) 7th edition tumor stage are associated with worse locoregional control and overall survival . Race has been observed as a prognostic factor for HPV‐negative OPSCC, but not HPV‐positive OPSCC .…”

Section: Introductionmentioning

confidence: 99%

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Prognostic factors for human papillomavirus–positive and negative oropharyngeal carcinomas

et al. 2018

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Section: Discussioncontrasting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Prognostic factors for human papillomavirus–positive and negative oropharyngeal carcinomas

et al. 2018

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“…Patients with HPV‐related OPC, who likely comprised the majority of the analytic population in the current study, are known to have lower rates of tobacco abuse compared with patients with traditional tobacco‐related HNC. However, the risk of OPC is highest in current and former smokers, and the results of the current study have demonstrated that nearly one‐half of survivors are diagnosed with tobacco abuse by year 5, which is known to increase the risk of CVD, stroke, COPD, tumor recurrence, and the development of new malignancies …”

Section: Discussionmentioning

confidence: 65%

“…However, the risk of OPC is highest in current and former smokers, and the results of the current study have demonstrated that nearly one-half of survivors are diagnosed with tobacco abuse by year 5, which is known to increase the risk of CVD, stroke, COPD, tumor recurrence, and the development of new malignancies. 9,[45][46][47][48][49] In addition, survivors are at moderately high risk of developing depression, anxiety, and alcohol abuse. Data have shown that the risk of suicide among survivors of HNC is nearly twice that of other cancer survivors, and that rate has increased since 2000.…”

Section: Discussionmentioning

confidence: 99%

Burden of comorbidities is higher among elderly survivors of oropharyngeal cancer compared with controls

Bigelow

Blackford

Eytan

et al. 2020

Cancer

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Background The prevalence of survivors of oropharyngeal cancer (OPC) is increasing due to improved survival for individuals with human papillomavirus (HPV)–related disease. Although elderly survivors of OPC are known to have a high burden of comorbidities, to the authors' knowledge it is unknown how this compares with a similar cohort without a history of cancer. Methods The current retrospective, cross‐sectional study included individuals with a first incident primary diagnosis of OPC from 2004 through 2011 from the Surveillance, Epidemiology, and End Results (SEER)–Medicare‐linked databases and matched controls. The baseline prevalence and subsequent incidence of comorbid conditions were identified. The association between comorbidity and overall survival was evaluated. Results A total of 2497 eligible patients with OPC were matched to 4994 noncancer controls. Baseline comorbidity was higher in cases (Charlson Comorbidity Index >0 for 48.5% of cases vs 35.8% of controls). At 5 years, cases were more likely than controls to develop comorbidities. Survivors of OPC were at high risk (≥20% cumulative prevalence by 5 years) of developing several comorbidities, including cardiovascular diseases, cerebrovascular disease, chronic obstructive pulmonary disease, and tobacco abuse, and were at moderately high risk (10%‐19% cumulative prevalence) of developing other conditions including carotid artery occlusive stroke, alcohol abuse, depression, and anxiety. In both cases and controls, the presence of the majority of comorbidities either at the time of diagnosis or during the follow‐up period was associated with worse survival. Conclusions Patients with OPC have a higher comorbidity burden compared with matched controls, both at baseline and during survivorship, the majority of which are associated with decreased survival. Oncologic surveillance of survivors of OPC should include screening for highly prevalent conditions.

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“…Although smoking has been proven to be a major prognostic factor for HNSCC, there are conflicting results with respect to the role of HPV status and smoking in survival . HPV16 positivity appears to have a greater effect on the prognosis of LSCC in never smokers than ever smokers . In our study, we compared survival outcomes of HPV16 DNA and/or p16 expression stratified by smoking status.…”

Section: Discussionmentioning

confidence: 83%

Prognostic implications of human papillomavirus status and p16 expression in laryngeal squamous cell carcinoma

et al. 2019

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Background The purpose of this study was to investigate significance of HPV16 DNA/p16 for survival of patients with laryngeal squamous cell carcinoma (LSCC). Methods HPV16 DNA and p16 status in 812 LSCC patients were determined. The survival was performed using Kaplan‐Meier estimates and Cox model. Results Compared with HPV negativity, adjusted HRs for HPV16 positivity were 0.57, 95% CI, 0.38 to 0.87; 0.60, 0.40 to 0.88; and 0.65, 0.46 to 0.94 for disease‐specific survival (DSS), recurrence‐free survival (RFS), and overall survival (OS), respectively. Additionally, for p16 expression, aHRs were 0.68, 95% CI, 0.48 to 0.96; 0.72, 0.52 to 0.98; and 0.73, 0.54 to 0.99 for DSS, RFS, and OS, respectively. Finally, for combined analysis, patients with both HPV16‐positivity/p16‐positivity had much better prognosis than those with either negativity. Such above survivals are more significantly better in never smokers. Conclusion Our findings suggest that HPV16/p16 may affect survival outcomes of LSCC patients, particularly in never smokers.

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Adverse effect of smoking on prognosis in human papillomavirus–associated oropharyngeal carcinoma

Abstract: Smoking was the only modifiable prognostic factor in HPV-positive patients. Therefore, active stop-smoking programs must be integrated in the routine management of patients to maximize treatment results. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1780-1787, 2016.

Cited by 21 publications

References 40 publications

Prognostic factors for human papillomavirus–positive and negative oropharyngeal carcinomas

Prognostic factors for human papillomavirus–positive and negative oropharyngeal carcinomas

Burden of comorbidities is higher among elderly survivors of oropharyngeal cancer compared with controls

Prognostic implications of human papillomavirus status and p16 expression in laryngeal squamous cell carcinoma

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