title: Oral cavity squamous cell carcinoma in never smokers: analysis of clinicopathologic characteristics and survival.
abstract: OBJECTIVE
  To examine the relationship between tobacco smoking history and the clinicopathologic and survival characteristics of patients with oral cavity squamous cell carcinoma (OCSCC).
  
  
  METHODS
  This is a retrospective review of 531 patients treated for OCSCC from January 1998 to December 2009 at a tertiary care medical center.
  
  
  RESULTS
  Thirty-two percent of OCSCC patients were never smokers. There were significant differences in tumor location between ever smokers and never smokers (p<0.001), with never smokers more likely to have oral tongue tumors. Smokers were significantly (p<0.001) more likely than never smokers to present with locally advanced (T3 or T4) disease (57.8% vs. 35.4%). Never smokers demonstrated improved overall survival (78.8 months in never smokers vs. 44.7 months in ever smokers, p=.03). However, there were no survival differences when the two groups were compared separately for locally early (T1/T2) or advanced (T3/T4) disease. For T1/T2 tumors, mean survival was 88.2 months for never smokers and 78.5 months for smokers (p=.10). For T3/T4 tumors, median survival was 29.1 months for never smokers and 23.8 months for smokers (p=.09).
  
  
  CONCLUSIONS
  Primary tumor location and T-status in OCSCC differed between never smokers and smokers. Compared to smokers, never smokers had fewer locally advanced tumors and better overall survival.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of California-San Francisco, San Francisco, CA 94115, USA.
authors.forename: Megan L
authors.initials: ML
authors.lastname: Durr
authors.forename: David
authors.initials: D
authors.lastname: Li
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Wang
mesh_terms: D002140:California / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology*; D009367:Neoplasm Staging / Q000379:methods*; D012189:Retrospective Studies; D012907:Smoking; D015996:Survival Rate / Q000639:trends; D013997:Time Factors