吸烟对人乳头瘤病毒相关口咽鳞状细胞癌特定分期生存的影响。
Impact of smoking on stage-specific survival in human papilloma virus-associated oropharyngeal squamous cell carcinoma.
机构信息
Department of Otolaryngology - Head and Neck Surgery, Louisiana State University Health Sciences Center & Feist-Weiller Cancer Center, Shreveport, Louisiana, USA.
Yale University School of Medicine, New Haven, Connecticut, USA.
出版信息
Head Neck. 2021 Sep;43(9):2698-2704. doi: 10.1002/hed.26745. Epub 2021 May 18.
BACKGROUND
The American Joint Committee on Cancer (AJCC) released a new staging system for human papilloma virus (HPV) positive oropharyngeal cancer (OPC) in their eighth edition. The role of smoking in HPV positive oropharyngeal cancer remains controversial and is not factored into the updated staging system.
METHODS
Single institutional, retrospective chart review of patients with HPV positive OPC from 2009 to 2017 was completed. Dichotomized smoking data were collected into 0-9 and ≥10 pack-year histories. Kaplan-Meier survival curves compared overall survival (OS) for smokers and nonsmokers.
RESULTS
Five-year OS was not statistically different in stage I or stage II HPV positive OPC comparing nonsmokers versus smokers, but worse in stage III smokers (38% vs. 76%, p < 0.05).
CONCLUSION
Greater than 10 pack-year smoking status may negatively affect survival in late stage HPV positive OPC but not in early stage disease. HPV positive smokers may require additional risk stratification.
背景
美国癌症联合委员会（AJCC）在其第八版中发布了新的人乳头瘤病毒（HPV）阳性口咽癌（OPC）分期系统。吸烟在 HPV 阳性口咽癌中的作用仍存在争议，并未纳入更新的分期系统。
方法
对 2009 年至 2017 年间 HPV 阳性 OPC 患者进行单机构回顾性图表审查。将二分类吸烟数据收集为 0-9 和≥10 包年史。Kaplan-Meier 生存曲线比较了吸烟者和非吸烟者的总生存率（OS）。
结果
在 I 期或 II 期 HPV 阳性 OPC 中，非吸烟者与吸烟者相比，5 年 OS 无统计学差异，但在 III 期吸烟者中较差（38%对 76%，p<0.05）。
结论
大于 10 包年的吸烟状况可能会对晚期 HPV 阳性 OPC 的生存产生负面影响，但对早期疾病没有影响。HPV 阳性吸烟者可能需要额外的风险分层。
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