Low risk of second primary malignancies among never smokers with human papillomavirus-associated index oropharyngeal cancers.
BACKGROUND: Among patients with index oropharyngeal cancer, second primary malignancies (SPMs) may be less common in cases of human papillomavirus (HPV)-associated tumors than HPV-negative tumors. Further modification of these SPM risks by smoking has not been reported. METHODS: SPM outcomes of 356 patients with incident oropharyngeal cancer were analyzed using Cox proportional hazards and Kaplan-Meier models. SPM risk and SPM-free survival were compared in HPV-seronegative patients, HPV-seropositive never smokers, and HPV-seropositive ever smokers. RESULTS: HPV-seropositive patients had a lower 5-year SPM rate than HPV-seronegative patients (5.6% vs 14.6%; p = .051). Compared to HPV-seronegative patients, HPV-seropositive never smokers had a 73% reduced SPM risk, and HPV-seropositive ever smokers had a 27% reduced SPM risk (trend p = .028). Although HPV-seronegative patients had SPMs in traditional locations, 70% of SPMs among HPV-seropositive patients were outside typical tobacco-related sites. CONCLUSION: HPV serologic status and smoking may stratify patients with index oropharyngeal cancers in terms of risk and location of SPMs.
Duke Scholars
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Related Subject Headings
- Smoking
- Risk Assessment
- Proportional Hazards Models
- Papillomavirus Infections
- Papillomaviridae
- Otorhinolaryngology
- Oropharyngeal Neoplasms
- Neoplasms, Second Primary
- Middle Aged
- Male
Citation
Published In
DOI
EISSN
Publication Date
Volume
Issue
Start / End Page
Location
Related Subject Headings
- Smoking
- Risk Assessment
- Proportional Hazards Models
- Papillomavirus Infections
- Papillomaviridae
- Otorhinolaryngology
- Oropharyngeal Neoplasms
- Neoplasms, Second Primary
- Middle Aged
- Male