The impact of tobacco smoking on survival of patients with oral squamous cell carcinoma: a population-based retrospective study

医学 比例危险模型 内科学 危险系数 基底细胞 戒烟 回顾性队列研究 肿瘤科 人口 饮酒量 生存分析 流行病学 外科 病理 置信区间 环境卫生 生物化学 化学
作者
Amanda Oester Andersen,Jakob Schmidt Jensen,Kathrine Kronberg Jakobsen,Helene Stampe,Kristoffer Juul Nielsen,Irene Wessel,Anders Christensen,Elo Andersen,Jeppe Friborg,Christian Grønhøj,Christian von Buchwald
出处
期刊:Acta Oncologica [Taylor & Francis]
卷期号:61 (4): 449-458 被引量:6
标识
DOI:10.1080/0284186x.2022.2033830
摘要

This article aims to evaluate the impact of smoking status, accumulated tobacco exposure (ATE), and smoking cessation on overall- and disease-free survival (OS and DFS) of patients with oral squamous cell carcinoma (OSCC).Patients with primary OSCC treated with curative intent between 2000 and 2019 in Copenhagen were included (n = 1808). Kaplan-Meier curves and multivariable Cox regression analyses were performed to compare the survival of patients with different smoking history. Interactions between ATE and (A) tumor subsite and (B) excessive alcohol consumption (EAC) on the survival were evaluated using multivariable Cox regression analyses with interaction terms.We included 1717 patients with known smoking status (62.8% males, median age: 64 years (IQR: 57-71 years)), who had a 5-year OS of 53.7% (95%CI: 49.8%-57.9%). Based on fully adjusted multivariable Cox regression analyses, significantly elevated hazard ratios (HRs) for OS and DFS were identified for current, but not former smokers, compared to never-smokers. An approximately linear relationship between continuous ATE and survival estimates was identified. ATE analyzed as a categorical variable showed significantly elevated HRs for OS of patients with all categories (060 PYs), however only for DFS of patients with >60 PYs, compared to 0 PYs. Furthermore, an unfavorable long-term prognosis was evident after >3.5 (OS) and >2.5 (DFS) years from diagnosis for patients who continued smoking compared to patients with smoking cessation at diagnosis. The survival estimates of patients with different tumor subsite and alcohol consumption differed with increasing ATE.Tobacco smoking (assessed as smoking status and ATE) was associated with inferior survival (OS and DFS) among patients with OSCC. Unfavorable long-term prognosis was significant for patients who continued smoking compared to patients with smoking cessation at diagnosis. The impact of ATE on survival of patients with OSCC may depend on the tumor subsite and/or alcohol consumption.
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