Survival Based on Smoking Status in Head and Neck Cancer

Abstract

Objective: 1) Assess the impact of smoking status on disease-specific and overall survival in head and neck cancer. 2) Identify subsite specific differences in survival related to smoking status.

Method: Retrospective analysis of a single institution database from 1980 through 2008. Patients were categorized by site of primary tumor and smoking status. Kaplan Meier analysis was used to calculate survival, and log rank and chi square analysis were used to identify significant differences.

Results: Significant overall and disease-specific survival differences were observed between current, previous, and non-smokers. Current smokers had a lower survival in all subsites except for oral cavity. The biggest differences were observed in the oropharynx subsite. 5-year disease-specific survival for oropharyngeal cancer was: current smokers 57.0%, non-smokers 86.9%, and previous smokers 81.8% (P < .05). Similar overall survival differences were observed. Smoking status did not impact on overall or disease-specific survival in oral cavity cancer.

Conclusion: While a significant focus in head and neck cancer has been on HPV and tumor biomarkers, it is important to recognize smoking as an important factor in survival outcome for head and neck cancer. Both nonsmokers and previous smokers have a survival advantage over current smokers.