Impact of Smoking on the Survival of Patients With High-risk HPV-positive HNSCC: A Meta-analysis

Moonef Alotaibi; Valeria Valova; Toni HÄnsel; Carmen Stromberger; Grzegorz Kofla; Heidi Olze; Iris Piwonski; Andreas Albers; Sebastian Ochsenreither; Annekatrin Coordes

doi:10.21873/invivo.12345

Impact of Smoking on the Survival of Patients With High-risk HPV-positive HNSCC: A Meta-analysis

In Vivo. 2021 Mar-Apr;35(2):1017-1026. doi: 10.21873/invivo.12345.

Authors

Moonef Alotaibi^#^{1

2}, Valeria Valova^#¹, Toni HÄnsel¹, Carmen Stromberger³, Grzegorz Kofla⁴, Heidi Olze¹, Iris Piwonski⁵, Andreas Albers⁶, Sebastian Ochsenreither^{7

8}, Annekatrin Coordes⁹

Affiliations

¹ Department of Otorhinolaryngology, Head and Neck Surgery (CVK and CCM), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
² King Fahad Medical City, Department of Otorhinolaryngology, Head and Neck Surgery, Riyadh, Kingdom of Saudi Arabia.
³ Department of Radiooncology (CVK), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁴ Department of Oncology (CVK), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁵ Institute of Pathology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁶ Department of Otorhinolaryngology (CBF), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁷ Department of Oncology (CBF), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁸ Charité Comprehensive Cancer Center, Berlin, Germany.
⁹ Department of Otorhinolaryngology, Head and Neck Surgery (CVK and CCM), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; annekatrin.coordes@charite.de.

^# Contributed equally.

Abstract

Background/aim: High risk Human papillomavirus (hr-HPV) and smoking are independant risk factors for head and neck squamous cell carcinomas (HNSCC). While hr-HPV⁺ HNSCC has a better prognosis than smoking-associated HNSCC no systematic data are yet available about the combined risk.

Patients and methods: We performed a meta-analysis to assess the overall survival of HNSCC patients relative to the hr-HPV and smoking status. A literature review up to November 2019 was conducted in PubMed and Cochrane Library using the search terms 'HPV, Smoking and HNSCC'.

Results: Nine out of 748 articles were included, 1,436 out of 2,080 patients were hr-HPV⁺ The prevalence of hr-HPV⁺ smokers was 36%. The meta-analysis showed a significantly better 5-year overall survival for HPV⁺ non-smokers compared to smokers with risk ratio of 1.94 (95% confidence intervaI=1.46-2.58).

Conclusion: Smoking is a negative prognostic factor for overall survival in patients with hr-HPV⁺ HNSCC and should thus be an important part of staging and treatment.

Keywords: HNSCC; HPV; ISH; PCR; p16; smoking.

Publication types

Meta-Analysis

MeSH terms

Head and Neck Neoplasms* / epidemiology
Humans
Papillomaviridae / genetics
Papillomavirus Infections* / complications
Papillomavirus Infections* / epidemiology
Smoking / adverse effects
Squamous Cell Carcinoma of Head and Neck / epidemiology