Continuation of smoking after treatment of laryngeal cancer: an independent prognostic factor?.
OBJECTIVE
The aim of the study is to examine if continuation of smoking after treatment is an independent factor affecting the prognosis of laryngeal cancer.


METHODS
A total of 153 patients met the inclusion criteria for this prospective study, and they were followed up for 12-60 months. Smoking cessation/continuation rates were recorded and associated with disease recurrence and overall patient survival.


RESULTS
The recurrence rate was 35.29%. Twenty-five percent of the patients continued smoking after treatment, 75% stopped. Of the patients who quit smoking, 28.69% died during the follow-up period, compared to 52.63% of those who continued (p = 0.0047). The respective recurrence rates were 28.7 and 55.26% (p = 0.0022). A stepwise multivariate Cox regression analysis eliminated potential confounders regarding the overall survival rate and confirmed that time between symptom onset and diagnosis, T and N stage and continuation of smoking after treatment are statistically significant factors. Among them, continuation of smoking was found to have the strongest correlation to the overall survival rate.


CONCLUSIONS
Continuation of smoking after treatment of laryngeal cancer is an independent negative prognostic factor. From a clinical standpoint, all patients with known laryngeal cancer should be strongly encouraged to quit smoking.
First ENT Department, Hippokrateion General Hospital, University of Athens, Athens, Greece.
Dimitrios
D
Kikidis
Petros V
PV
Vlastarakos
Leonidas
L
Manolopoulos
Ioannis
I
Yiotakis
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000401:mortality* / Q000523:psychology* / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality* / Q000523:psychology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000523:psychology*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking; D016540:Smoking Cessation; D015996:Survival Rate