Impact of comorbidity, smoking, and alcohol on therapy and survival in oropharyngeal carcinoma

A retrospective analysis of 357 patients (pat.) with oropharyngeal carcinoma (OPCA) showed the unchanged positive role of surgery, even in the early stages and independent of HPV status. Disease-specific survival (DSS) was better than overall survival (OS) with a significant survival advantage of HPV+. The objective of this study is to determine whether the less favorable OS compared to DSS is due to age, comorbidity (CoMo), nicotine, or alcohol. Retrospectively, data from 357 OPCA pat. (249 m, 108 w, age Ø63.2 years) of all stages were examined, smoking behaviour, alcohol consumption, and CoMo were recorded, and statistically analyzed with therapy/progression and HPV status in relation to DSS and OS. 134 (42%) have CoMo, 141 (45,2%) actively smoke, 23,4% former, and 31,4% never smokers; 52 (16,7%) regularly drink alcohol, 17% no longer do. DSS: HPV+survive significantly better. Non- and ex-smokers without CoMo also; with CoMo nonsmokers survive better than ex- and active smokers. Alcohol consumption has no influence. Regarding OS, HPV+without CoMo survive best and HPV- with coMo survive worst. Smoking abrogates the positive effect of HPV; alcohol again has no influence. In the surgery+/- adjuvant group, nicotine, alcohol, and CoMo are without sgnificance for survival. In contrast, in the prim- RCT group DSS and OS of non- and ex-smokers is significantly better while that of patients with CoMo is less favorable. Regarding OS, non-smokers survive best and pat. with CoMo significantly worse. Alcohol has no influence.