title: Survival analysis of head and neck squamous cell carcinoma: influence of smoking and drinking.
abstract: BACKGROUND
  Head and neck squamous cell carcinomas (HNSCCs) are associated with tobacco and alcohol; however, the prognostic relevance of these substances is unclear.
  
  
  METHODS
  Univariate and multivariate survival analyses were performed for patients with (n = 1829) and without (n = 183) substance use.
  
  
  RESULTS
  HNSCC-specific survival (death due to primary-HNSCC or recurrent HNSCC) and HNSCC/second primary tumor-specific survival (death due to primary-HNSCC or recurrent HNSCC or second primary tumor) were not significantly different for patients who smoked and drank alcohol (hazard ratio [HR], 1.26; 95% confidence interval [CI], 0.86-1.85) and those who did not (HR, 1.34; 95% CI, 0.96-1.88). Overall survival was significantly affected; HR for patients who smoked and drank alcohol was 1.50 (95% CI, 1.16-1.93).
  
  
  CONCLUSIONS
  Although tobacco and alcohol use are the main risk factors for development of HNSCC, disease outcome was comparable in patients who did or did not use these substances. Tobacco and alcohol use affected overall survival, which emphasizes the importance of substance use cessation.
authors.affiliation: Department of Otolaryngology, University Medical Center Utrecht, Utrecht, The Netherlands. F.Farshadpour@umcutrecht.nl
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Farshadpour
authors.forename: Hanneke
authors.initials: H
authors.lastname: Kranenborg
authors.forename: Eveline Van Beeck
authors.initials: EV
authors.lastname: Calkoen
authors.forename: Gerrit Jan
authors.initials: GJ
authors.lastname: Hordijk
authors.forename: Ron
authors.initials: R
authors.lastname: Koole
authors.forename: Piet J
authors.initials: PJ
authors.lastname: Slootweg
authors.forename: Chris H
authors.initials: CH
authors.lastname: Terhaard
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000401:mortality; D002277:Carcinoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell; D002423:Cause of Death; D015331:Cohort Studies; D016001:Confidence Intervals; D016208:Databases, Factual; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D018307:Neoplasms, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009426:Netherlands; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects* / Q000401:mortality; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis