Survival analysis of head and neck squamous cell carcinoma: influence of smoking and drinking.
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.
Farshadpour
Farzaneh
F
Department of Otolaryngology, University Medical Center Utrecht, Utrecht, The Netherlands. F.Farshadpour@umcutrecht.nl
Kranenborg
Hanneke
H
Calkoen
Eveline Van Beeck
EV
Hordijk
Gerrit Jan
GJ
Koole
Ron
R
Slootweg
Piet J
PJ
Terhaard
Chris H
CH
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