Tobacco cessation after head and neck cancer diagnosis is an independent predictor of treatment response and long-term survival

Matthew Krutz; Pawan Acharya; Geraldine Chissoe; Vijay Raj; Lane Driskill; Greg Krempl; Daniel Zhao; Rachad Mhawej; Lurdes Queimado

doi:10.1016/j.oraloncology.2022.106072

Tobacco cessation after head and neck cancer diagnosis is an independent predictor of treatment response and long-term survival

Oral Oncol. 2022 Nov:134:106072. doi: 10.1016/j.oraloncology.2022.106072. Epub 2022 Aug 19.

Authors

Matthew Krutz¹, Pawan Acharya², Geraldine Chissoe¹, Vijay Raj¹, Lane Driskill¹, Greg Krempl¹, Daniel Zhao³, Rachad Mhawej⁴, Lurdes Queimado⁵

Affiliations

¹ Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
² Department of Biostatistics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
³ Department of Biostatistics, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
⁴ Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. Electronic address: Rachad-Mhawej@ouhsc.edu.
⁵ Department of Otolaryngology Head and Neck Surgery, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Department of Cell Biology, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; TSET Health Promotion Research Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. Electronic address: lurdes-queimado@ouhsc.edu.

Abstract

Head and neck squamous cell carcinoma (HNSCC) patients who are current smokers when diagnosed have inferior clinical outcomes compared to never-smokers or previous smokers. However, the impact of quitting after HNSCC diagnosis has not been quantified. In this retrospective, case-control study (n = 134), the odds of complete response to first-line therapy were 3.7 times higher among smokers at diagnosis who quit before treatment initiation (quitters; n = 55) than among those continuing to smoke (p = 0.03). Disease-free survival was also higher among quitters (aHR, 0.33; 95 % CI, 0.12-0.90; p = 0.029). Quitters were 67 % less likely to die of all causes than active smokers (aHR, 0.33; 95 % CI, 0.15-0.71; p = 0.004). These data show for the first time that, smoking cessation after HNSCC diagnosis is predictive of higher therapy efficacy and long-term survival.

Keywords: Oral cancer; Oropharyngeal cancer; Response to therapy; Squamous cell carcinoma; Survival; Tobacco cessation.

Publication types

Letter
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't

MeSH terms

Case-Control Studies
Head and Neck Neoplasms* / diagnosis
Head and Neck Neoplasms* / therapy
Humans
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck / diagnosis
Tobacco Use Cessation*

Abstract

Publication types

MeSH terms

Grants and funding