Oncotarget

Research Papers:

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 and Christian von Buchwald

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Oncotarget. 2019; 10:4655-4663. https://doi.org/10.18632/oncotarget.27079

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Abstract

Christian Grønhøj1, Jakob Schmidt Jensen1, Steffen Wagner2, Christian Dehlendorff3, Jeppe Friborg4, Elo Andersen5, Claus Wittekindt2, Nora Würdemann2,6, Shachi Jenny Sharma2,6, Stefan Gattenlöhner7, Jens Peter Klussmann2,6 and Christian von Buchwald1

1 Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

2 Department of Otorhinolaryngology, Head and Neck Surgery, University of Giessen, Giessen, Germany

3 Department of Statistics and Pharmacoepidemiology, Danish Cancer Society Research Center, Copenhagen, Denmark

4 Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

5 Department of Oncology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark

6 Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty, University of Cologne, Cologne, Germany

7 Department of Pathology, University of Giessen, Giessen, Germany

Correspondence to:

Christian Grønhøj,email: christian.groenhoej@regionh.dk

Keywords: oropharyngeal cancer; human papillomavirus; smoking; survival

Received: May 01, 2019     Accepted: June 29, 2019     Published: July 23, 2019

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.


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