Abstract：
OBJECTIVE: While tobacco use is understood to negatively impact HPV+ oropharyngeal squamous cell carcinoma (OPSCC) outcomes, debate remains as to how this impact differs between cohorts. Multiple smoking metrics have been identified as having the greatest prognostic significance, and some recent works have found smoking to have no significant impact. Herein, we show through an analysis of four common smoking metrics that while smoking impacts overall survival (OS), it has a limited impact on recurrence-free survival (RFS) in our cohort.
METHODS: We conducted a retrospective review of patients treated for HPV+ OPSCC in our health system from 2012 to 2019. Patients with metastatic disease or concurrent second primaries were excluded. Four metrics of tobacco use were assessed: current/former/never smokers, ever/never smokers, and smokers with >10 or >20 pack-year (PY) smoking histories. Our main outcomes were 3-year RFS and OS.
RESULTS: Three hundred and sixty-seven patients met inclusion criteria. 37.3% of patients (137/367) were never-smokers; 13.8% of patients (51/367) were currently smoking at diagnosis and 48.8% of patients (179/367) were former smokers. No tobacco-use metric significantly impacted 3-year RFS. On univariate analysis, all smoking metrics yielded inferior OS. On multivariate analysis, current and ever smoking status significantly impacted 3-year OS.
CONCLUSIONS: The impact of tobacco use on HPV+ OPSCC outcomes is not universal, but may instead be modulated by other cohort-specific factors. The impact of smoking may decrease as rates of tobacco use decline.
METHODS: 3 (Cohort and case-control studies) Laryngoscope, 134:3158-3164, 2024.
METHODS: We conducted a retrospective review of patients treated for HPV+ OPSCC in our health system from 2012 to 2019. Patients with metastatic disease or concurrent second primaries were excluded. Four metrics of tobacco use were assessed: current/former/never smokers, ever/never smokers, and smokers with >10 or >20 pack-year (PY) smoking histories. Our main outcomes were 3-year RFS and OS.
RESULTS: Three hundred and sixty-seven patients met inclusion criteria. 37.3% of patients (137/367) were never-smokers; 13.8% of patients (51/367) were currently smoking at diagnosis and 48.8% of patients (179/367) were former smokers. No tobacco-use metric significantly impacted 3-year RFS. On univariate analysis, all smoking metrics yielded inferior OS. On multivariate analysis, current and ever smoking status significantly impacted 3-year OS.
CONCLUSIONS: The impact of tobacco use on HPV+ OPSCC outcomes is not universal, but may instead be modulated by other cohort-specific factors. The impact of smoking may decrease as rates of tobacco use decline.
METHODS: 3 (Cohort and case-control studies) Laryngoscope, 134:3158-3164, 2024.
摘要：
目的：虽然烟草使用对HPV+口咽鳞状细胞癌（OPSCC）结局有负面影响，关于这种影响在队列之间有何不同，仍有争议。多种吸烟指标已被确定为具有最大的预后意义，最近的一些工作发现吸烟没有重大影响。在这里，我们通过对四种常见吸烟指标的分析显示，虽然吸烟会影响总生存期(OS)，在我们的队列中,它对无复发生存期(RFS)的影响有限.
方法：我们对2012年至2019年在我们的卫生系统中接受HPV+OPSCC治疗的患者进行了回顾性审查。排除转移性疾病或并发第二原发的患者。评估了四个烟草使用指标：当前/以前/从不吸烟者，曾经/从不吸烟者，和>10或>20包年(PY)吸烟史的吸烟者。我们的主要结果是3年RFS和OS。
结果：三百六十七名患者符合纳入标准。37.3%的患者（137/367）从不吸烟者；13.8%的患者（51/367）目前在诊断时吸烟，48.8%的患者（179/367）以前吸烟。无烟草使用指标显着影响3年RFS。在单变量分析中，所有吸烟指标均产生较差的OS。在多变量分析中，当前和以往的吸烟状况显著影响3年OS。
结论：烟草使用对HPV+OPSCC结局的影响并不普遍，但可能会受到其他队列特异性因素的调节。吸烟的影响可能会随着烟草使用率的下降而下降。
方法：III（队列和病例对照研究）喉镜，2024.
方法：我们对2012年至2019年在我们的卫生系统中接受HPV+OPSCC治疗的患者进行了回顾性审查。排除转移性疾病或并发第二原发的患者。评估了四个烟草使用指标：当前/以前/从不吸烟者，曾经/从不吸烟者，和>10或>20包年(PY)吸烟史的吸烟者。我们的主要结果是3年RFS和OS。
结果：三百六十七名患者符合纳入标准。37.3%的患者（137/367）从不吸烟者；13.8%的患者（51/367）目前在诊断时吸烟，48.8%的患者（179/367）以前吸烟。无烟草使用指标显着影响3年RFS。在单变量分析中，所有吸烟指标均产生较差的OS。在多变量分析中，当前和以往的吸烟状况显著影响3年OS。
结论：烟草使用对HPV+OPSCC结局的影响并不普遍，但可能会受到其他队列特异性因素的调节。吸烟的影响可能会随着烟草使用率的下降而下降。
方法：III（队列和病例对照研究）喉镜，2024.
