title: Heterogeneous impact of alcohol consumption according to treatment method on survival in head and neck cancer: A prospective study.
abstract: Alcohol consumption is an established risk factor, and also a potential prognostic factor, for squamous cell carcinoma of the head and neck (HNSCC). However, little is known about whether the prognostic impact of alcohol consumption differs by treatment method. We evaluated the association between alcohol drinking and survival by treatment method to the primary site in 427 patients with HNSCC treated between 2005 and 2013 at Aichi Cancer Center Central Hospital (Nagoya, Japan). The impact of alcohol on prognosis was measured by multivariable Cox regression analysis adjusted for established prognostic factors. Among all HNSCC patients, the overall survival rate was significantly poorer with increased levels of alcohol consumption in multivariable analysis (trend P = 0.038). Stratification by treatment method and primary site revealed that the impact of drinking was heterogeneous. Among laryngopharyngeal cancer (laryngeal, oropharyngeal, and hypopharyngeal cancer) patients receiving radiotherapy (n = 141), a significant dose-response relationship was observed (trend P = 0.034). In contrast, among laryngopharyngeal cancer patients treated with surgery (n = 80), no obvious impact of alcohol was observed. This heterogeneity in the impact of alcohol between surgery and radiotherapy was significant (for interaction, P = 0.048). Furthermore, among patients with oral cavity cancer treated by surgery, a significant impact of drinking on survival was seen with tongue cancer, but not with non-tongue oral cancer. We observed a significant inverse association between alcohol drinking and prognosis among HNSCC patients, and its impact was heterogeneous by treatment method and primary site.
authors: Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan.|Department of Otolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
authors: Michi
authors: M
authors: Sawabe
authors: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.|Department of Epidemiology, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
authors: Hidemi
authors: H
authors: Ito
authors: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
authors: Isao
authors: I
authors: Oze
authors: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.
authors: Satoyo
authors: S
authors: Hosono
authors: Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan.|Department of Otolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
authors: Daisuke
authors: D
authors: Kawakita
authors: Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan.|Department of Epidemiology, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
authors: Hideo
authors: H
authors: Tanaka
authors: Department of Head and Neck Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors: Yasuhisa
authors: Y
authors: Hasegawa
authors: Department of Otolaryngology, Head and Neck Surgery, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
authors: Shingo
authors: S
authors: Murakami
authors: Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan.|Department of Epidemiology, Nagoya City University Graduate School of Medicine, Nagoya, Japan.
authors: Keitaro
authors: http://orcid.org/0000-0003-1761-6314
authors: K
authors: Matsuo
mesh_terms: D000428:Alcohol Drinking; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010610:Pharyngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D011379:Prognosis; D011446:Prospective Studies; D012907:Smoking; D016896:Treatment Outcome
keywords: Adverse effect; alcohol; head and neck cancer; prognostic factor; treatment