Skip to main content
SpringerLink
Log in

Understanding Interactions of Smoking on Prognosis of HPV-Associated Oropharyngeal Cancers

  • Commentary
  • Published:
Advances in Therapy Aims and scope Submit manuscript

Abstract

The new 8th edition AJCC/UICC staging system for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC), developed to account for improved survival outcomes over HPV-negative cancers, includes anatomic features strictly associated with tumor-node-metastasis (TNM) and does not account for patient-specific characteristics that may impact prognosis. This commentary evaluates the evidence of smoking as an adverse prognostic factor in HPV-associated OPSCC. We review the multifactorial biological, clinical, and social/behavioral characteristics of smokers with OPSCC that impact outcomes, discuss current challenges with incorporating smoking history in prognostic classifications, and consider opportunities for future investigation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Amin MB, Edge S, Greene F et al, editors. AJCC cancer staging manual. 8th ed. New York: Springer; 2017.

  2. Kumar B, Cordell KG, Lee JS, et al. EGFR, p16, HPV titer, Bcl-xL and p53, sex, and smoking as indicators of response to therapy and survival in oropharyngeal cancer. J Clin Oncol. 2008;26:3128–37.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Maxwell JH, Kumar B, Feng FY, et al. Tobacco use in human papillomavirus-positive advanced oropharynx cancer patients related to increased risk of distant metastases and tumor recurrence. Clin Cancer Res. 2010;16:1226–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. O’Sullivan B, Huang SH, Siu LL, et al. Deintensification candidate subgroups in human papillomavirus-related oropharyngeal cancer according to minimal risk of distant metastasis. J Clin Oncol. 2013;31:543–50.

    Article  PubMed  Google Scholar 

  5. Vainshtein JM, Spector ME, McHugh JB, et al. Refining risk stratification for locoregional failure after chemoradiotherapy in human papillomavirus-associated oropharyngeal cancer. Oral Oncol. 2014;50:513–9.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Marur S, Li S, Cmelak AJ, Gillison ML, et al. E1308: phase II trial of induction chemotherapy followed by reduced-dose radiation and weekly cetuximab in patients with HPV-associated resectable squamous cell carcinoma of the oropharynx—ECOG-ACRIN Cancer Research Group. J Clin Oncol. 2017;35:490–7.

    Article  CAS  PubMed  Google Scholar 

  7. Platek AJ, Jayaprakash V, Merzianu M, et al. Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation. Laryngoscope. 2016;126:2733–8.

    Article  PubMed  Google Scholar 

  8. Liskamp CP, Janssens GO, Bussink J, Melchers WJ, Kaanders JH, Verhoef CG. Adverse effect of smoking on prognosis in human papillomavirus-associated oropharyngeal carcinoma. Head Neck. 2016;38:1780–7.

    Article  PubMed  Google Scholar 

  9. The Cancer Genome Atlas Network. Comprehensive genomic characterization of head and neck squamous cell carcinomas. Nature. 2015;517:576–82.

    Article  PubMed Central  Google Scholar 

  10. Hong A, Zhang X, Jones D, et al. Relationships between p53 mutation, HPV status and outcome in oropharyngeal squamous cell carcinoma. Radiother Oncol. 2016;118:342–9.

    Article  CAS  PubMed  Google Scholar 

  11. Qiu F, Liang CL, Liu H, et al. Impacts of cigarette smoking on immune responsiveness: up and down or upside down? Oncotarget. 2017;8:268–84.

    PubMed  Google Scholar 

  12. Samuels SE, Eisbruch A, Beitler JJ, et al. Management of locally advanced HPV-related oropharyngeal squamous cell carcinoma: where are we? Eur Arch Otorhinolaryngol. 2016;273:2877–94.

    Article  PubMed  Google Scholar 

  13. Petros WP, Younis IR, Ford JN, Weed SA. Effects of tobacco smoking and nicotine on cancer treatment. Pharmacotherapy. 2012;32:920–31.

    Article  CAS  PubMed  Google Scholar 

  14. Bøje CR. Impact of comorbidity on treatment outcome in head and neck squamous cell carcinoma—a systematic review. Radiother Oncol. 2014;110:81–90.

    Article  PubMed  Google Scholar 

  15. Liskamp CP, Janssens GO, Bussink J, Melchers WJ, Kaanders JH, Verhoef CG. Adverse effect of smoking on prognosis in human papillomavirus-associated oropharyngeal carcinoma. Head Neck. 2016;38:1780–7.

    Article  PubMed  Google Scholar 

  16. van der Schroeff MP, van de Schans SA, Piccirillo JF, Langeveld TP, Baatenburg de Jong RJ, Janssen-Heijnen ML. Conditional relative survival in head and neck squamous cell carcinoma: permanent excess mortality risk for long-term survivors. Head Neck. 2010;32:1613–8.

    Article  PubMed  Google Scholar 

  17. Takes RP, Rinaldo A, Silver CE, et al. Future of the TNM classification and staging system in head and neck cancer. Head Neck. 2010;32:1693–711.

    Article  PubMed  Google Scholar 

  18. Chu KP, Habbous S, Kuang Q, et al. Socioeconomic status, human papillomavirus, and overall survival in head and neck squamous cell carcinomas in Toronto, Canada. Cancer Epidemiol. 2016;40:102–12.

    Article  CAS  PubMed  Google Scholar 

  19. Sterba KR, Garrett-Mayer E, Carpenter MJ, et al. Smoking status and symptom burden in surgical head and neck cancer patients. Laryngoscope. 2017;127:127–33.

    Article  PubMed  Google Scholar 

  20. Prochaska JJ, Das S, Young-Wolff KC. Smoking, mental illness, and public health. Annu Rev Public Health. 2017;38:165–85.

    Article  PubMed  Google Scholar 

  21. Mdodo R, Frazier EL, Dube SR, et al. Cigarette smoking prevalence among adults with HIV compared with the general adult population in the United States: cross-sectional surveys. Ann Intern Med. 2015;162:335–44.

    Article  PubMed  Google Scholar 

  22. Maier H, Zöller J, Herrmann A, Kreiss M, Heller WD. Dental status and oral hygiene in patients with head and neck cancer. Otolaryngol Head Neck Surg. 1993;108:655–61.

    Article  CAS  PubMed  Google Scholar 

  23. Teppo H, Alho OP. Comorbidity and diagnostic delay in cancer of the larynx, tongue and pharynx. Oral Oncol. 2009;45:692–5.

    Article  PubMed  Google Scholar 

  24. Walline HM, Komarck C, McHugh JB, et al. High-risk human papillomavirus detection in oropharyngeal, nasopharyngeal, and oral cavity cancers: comparison of multiple methods. JAMA Otolaryngol Head Neck Surg. 2013;139:1320–7.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Nauta IH, Rietbergen MM, Vanbokhoven AAJD, et al. Evaluation of the 8th TNM classification on p16-positive oropharyngeal squamous cell carcinomas in the Netherlands, and the importance of additional HPV DNA-testing. Ann Oncol. 2018. https://doi.org/10.1093/annonc/mdy060.

    PubMed  Google Scholar 

  26. Rietbergen MM, Snijders PJ, Beekzada D, et al. Molecular characterization of p16-immunopositive but HPV DNA-negative oropharyngeal carcinomas. Int J Cancer. 2014;134:2366–72.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

Funding

No funding or sponsorship was received for this study or publication of this article.

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICJME) criteria for authorship of this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Missak Haigentz Jr, Carlos Suarez, Primoz Strojan, Juan P. Rodrigo, Alessandra Rinaldo, Carol R. Bradford, June Corry, Robert P. Takes, and Alfio Ferlito have nothing to disclose.

Compliance with Ethics Guidelines

This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors.

Author information

Authors and Affiliations

  1. Division of Oncology, Department of Medicine, Morristown Medical Center/Atlantic Health System, Morristown, NJ, USA

    Missak Haigentz Jr.

  2. Departments of Medicine (Oncology) and Otorhinolaryngology-Head & Neck Surgery, Albert Einstein College of Medicine, Bronx, NY, USA

    Missak Haigentz Jr.

  3. Instituto Universitario de Oncología del Principado de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias and CIBERONC, ISCIII, University of Oviedo, Oviedo, Spain

    Carlos Suarez

  4. Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia

    Primoz Strojan

  5. Department of Otolaryngology, Hospital Universitario Central de Asturias and Instituto Universitario de Oncología del Principado de Asturias, CIBERONC, Oviedo, Spain

    Juan P. Rodrigo

  6. University of Udine School of Medicine, Udine, Italy

    Alessandra Rinaldo

  7. Department of Otolaryngology, University of Michigan, Ann Arbor, USA

    Carol R. Bradford

  8. GenesisCare Radiation Oncology, Division Radiation Oncology, St. Vincent’s Hospital, Melbourne, Australia

    June Corry

  9. Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands

    Robert P. Takes

  10. Coordinator of the International Head and Neck Scientific Group, Padua, Italy

    Alfio Ferlito

Authors
  1. Missak Haigentz Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Carlos Suarez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Primoz Strojan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Juan P. Rodrigo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Alessandra Rinaldo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Carol R. Bradford
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. June Corry
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Robert P. Takes
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Alfio Ferlito
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Missak Haigentz Jr..

Additional information

Enhanced content

To view enhanced content for this article go to https://doi.org/10.6084/m9.figshare.5903569.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Haigentz, M., Suarez, C., Strojan, P. et al. Understanding Interactions of Smoking on Prognosis of HPV-Associated Oropharyngeal Cancers. Adv Ther 35, 255–260 (2018). https://doi.org/10.1007/s12325-018-0682-4

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12325-018-0682-4

Keywords

Search

Navigation