Human papillomavirus, smoking status and outcomes in tonsillar squamous cell carcinoma

Angela Hong, A Martin, Mark Chatfield, Deanna Jones, Mei Zhang, Bruce Armstrong, C Soon Lee, Gerry Harnett, Christopher Milross, Jonathan Clark, Michael Elliott, Robert Smee, June Corry, Chen Liu, Sando Porceddu, Guy Rees, Barbara Rose

Research output: Contribution to journalArticleResearchpeer-review

Abstract

It is now clear that the two separate entitles of tonsillar cancer, HPV induced and non-HPV induced (smoking induced), have significantly different presenting stage and outcomes. A significant proportion of patients with human papillomavirus positive tonsillar cancer have had exposure to smoking. We examined the combined effect of human papillomavirus and smoking on the outcomes and determined whether smoking can modify the beneficial effect of human papillomavirus. A total of 403 patients from nine centers were followed up for recurrence or death for a median of 38 months. Determinants of the rate of loco-regional recurrence, death from tonsillar cancer and overall survival were modeled using Cox regression. Smoking status was a significant predictor of overall survival (p = 0.04). There were nonstatistically significant trends favoring never smokers for loco-regional recurrence and disease specific survival. In addition, there was no statistically significant interactions between smoking and human papillomavirus (p-values for the interaction were 0.26 for loco-regional recurrence, 0.97 for disease specific survival and 0.73 for overall survival). The effect of smoking on loco-regional recurrence and disease specific survival outcomes was not statistically significant, nor was there significant evidence that the effect of smoking status on these outcomes was modified by HPV status. Irrespective of HPV status, however, smokers did have poorer overall survival than never-smokers, presumably due to effects of smoking that are unrelated to the primary cancer.
Original languageEnglish
Pages (from-to)2748-2754
Number of pages7
JournalInternational Journal of Cancer
Volume132
Issue number12
DOIs
Publication statusPublished - 2013

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Squamous Cell Carcinoma
Smoking
Tonsillar Neoplasms
Survival
Recurrence
Neoplasms

Cite this

Hong, A., Martin, A., Chatfield, M., Jones, D., Zhang, M., Armstrong, B., ... Rose, B. (2013). Human papillomavirus, smoking status and outcomes in tonsillar squamous cell carcinoma. International Journal of Cancer, 132(12), 2748-2754. https://doi.org/10.1002/ijc.27956
Hong, Angela ; Martin, A ; Chatfield, Mark ; Jones, Deanna ; Zhang, Mei ; Armstrong, Bruce ; Lee, C Soon ; Harnett, Gerry ; Milross, Christopher ; Clark, Jonathan ; Elliott, Michael ; Smee, Robert ; Corry, June ; Liu, Chen ; Porceddu, Sando ; Rees, Guy ; Rose, Barbara. / Human papillomavirus, smoking status and outcomes in tonsillar squamous cell carcinoma. In: International Journal of Cancer. 2013 ; Vol. 132, No. 12. pp. 2748-2754.
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abstract = "It is now clear that the two separate entitles of tonsillar cancer, HPV induced and non-HPV induced (smoking induced), have significantly different presenting stage and outcomes. A significant proportion of patients with human papillomavirus positive tonsillar cancer have had exposure to smoking. We examined the combined effect of human papillomavirus and smoking on the outcomes and determined whether smoking can modify the beneficial effect of human papillomavirus. A total of 403 patients from nine centers were followed up for recurrence or death for a median of 38 months. Determinants of the rate of loco-regional recurrence, death from tonsillar cancer and overall survival were modeled using Cox regression. Smoking status was a significant predictor of overall survival (p = 0.04). There were nonstatistically significant trends favoring never smokers for loco-regional recurrence and disease specific survival. In addition, there was no statistically significant interactions between smoking and human papillomavirus (p-values for the interaction were 0.26 for loco-regional recurrence, 0.97 for disease specific survival and 0.73 for overall survival). The effect of smoking on loco-regional recurrence and disease specific survival outcomes was not statistically significant, nor was there significant evidence that the effect of smoking status on these outcomes was modified by HPV status. Irrespective of HPV status, however, smokers did have poorer overall survival than never-smokers, presumably due to effects of smoking that are unrelated to the primary cancer.",
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Hong, A, Martin, A, Chatfield, M, Jones, D, Zhang, M, Armstrong, B, Lee, CS, Harnett, G, Milross, C, Clark, J, Elliott, M, Smee, R, Corry, J, Liu, C, Porceddu, S, Rees, G & Rose, B 2013, 'Human papillomavirus, smoking status and outcomes in tonsillar squamous cell carcinoma', International Journal of Cancer, vol. 132, no. 12, pp. 2748-2754. https://doi.org/10.1002/ijc.27956

Human papillomavirus, smoking status and outcomes in tonsillar squamous cell carcinoma. / Hong, Angela; Martin, A; Chatfield, Mark; Jones, Deanna; Zhang, Mei; Armstrong, Bruce; Lee, C Soon; Harnett, Gerry; Milross, Christopher; Clark, Jonathan; Elliott, Michael; Smee, Robert; Corry, June; Liu, Chen; Porceddu, Sando; Rees, Guy; Rose, Barbara.

In: International Journal of Cancer, Vol. 132, No. 12, 2013, p. 2748-2754.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Human papillomavirus, smoking status and outcomes in tonsillar squamous cell carcinoma

AU - Hong, Angela

AU - Martin, A

AU - Chatfield, Mark

AU - Jones, Deanna

AU - Zhang, Mei

AU - Armstrong, Bruce

AU - Lee, C Soon

AU - Harnett, Gerry

AU - Milross, Christopher

AU - Clark, Jonathan

AU - Elliott, Michael

AU - Smee, Robert

AU - Corry, June

AU - Liu, Chen

AU - Porceddu, Sando

AU - Rees, Guy

AU - Rose, Barbara

PY - 2013

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N2 - It is now clear that the two separate entitles of tonsillar cancer, HPV induced and non-HPV induced (smoking induced), have significantly different presenting stage and outcomes. A significant proportion of patients with human papillomavirus positive tonsillar cancer have had exposure to smoking. We examined the combined effect of human papillomavirus and smoking on the outcomes and determined whether smoking can modify the beneficial effect of human papillomavirus. A total of 403 patients from nine centers were followed up for recurrence or death for a median of 38 months. Determinants of the rate of loco-regional recurrence, death from tonsillar cancer and overall survival were modeled using Cox regression. Smoking status was a significant predictor of overall survival (p = 0.04). There were nonstatistically significant trends favoring never smokers for loco-regional recurrence and disease specific survival. In addition, there was no statistically significant interactions between smoking and human papillomavirus (p-values for the interaction were 0.26 for loco-regional recurrence, 0.97 for disease specific survival and 0.73 for overall survival). The effect of smoking on loco-regional recurrence and disease specific survival outcomes was not statistically significant, nor was there significant evidence that the effect of smoking status on these outcomes was modified by HPV status. Irrespective of HPV status, however, smokers did have poorer overall survival than never-smokers, presumably due to effects of smoking that are unrelated to the primary cancer.

AB - It is now clear that the two separate entitles of tonsillar cancer, HPV induced and non-HPV induced (smoking induced), have significantly different presenting stage and outcomes. A significant proportion of patients with human papillomavirus positive tonsillar cancer have had exposure to smoking. We examined the combined effect of human papillomavirus and smoking on the outcomes and determined whether smoking can modify the beneficial effect of human papillomavirus. A total of 403 patients from nine centers were followed up for recurrence or death for a median of 38 months. Determinants of the rate of loco-regional recurrence, death from tonsillar cancer and overall survival were modeled using Cox regression. Smoking status was a significant predictor of overall survival (p = 0.04). There were nonstatistically significant trends favoring never smokers for loco-regional recurrence and disease specific survival. In addition, there was no statistically significant interactions between smoking and human papillomavirus (p-values for the interaction were 0.26 for loco-regional recurrence, 0.97 for disease specific survival and 0.73 for overall survival). The effect of smoking on loco-regional recurrence and disease specific survival outcomes was not statistically significant, nor was there significant evidence that the effect of smoking status on these outcomes was modified by HPV status. Irrespective of HPV status, however, smokers did have poorer overall survival than never-smokers, presumably due to effects of smoking that are unrelated to the primary cancer.

U2 - 10.1002/ijc.27956

DO - 10.1002/ijc.27956

M3 - Article

VL - 132

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EP - 2754

JO - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

IS - 12

ER -