Continuation of Smoking after Treatment of Laryngeal Cancer: An Independent Prognostic Factor?

Abstract

Aim: The aim of the study is to examine if continuation of smoking after treatment is an independent factor affecting the prognosis of laryngeal cancer. Materials and Methods: A total of 153 patients met the inclusion criteria for this prospective study, and they were followed up for 12–60 months. Smoking cessation/continuation rates were recorded and associated with disease recurrence and overall patient survival. Results: The recurrence rate was 35.29%. Twenty-five percent of the patients continued smoking after treatment, 75% stopped. Of the patients who quit smoking, 28.69% died during the follow-up period, compared to 52.63% of those who continued (p = 0.0047). The respective recurrence rates were 28.7 and 55.26% (p = 0.0022). A stepwise multivariate Cox regression analysis eliminated potential confounders regarding the overall survival rate and confirmed that time between symptom onset and diagnosis, T and N stage and continuation of smoking after treatment are statistically significant factors. Among them, continuation of smoking was found to have the strongest correlation to the overall survival rate. Conclusion: Continuation of smoking after treatment of laryngeal cancer is an independent negative prognostic factor. From a clinical standpoint, all patients with known laryngeal cancer should be strongly encouraged to quit smoking.

Systematic Review of Tobacco Use after Lung or Head/Neck Cancer Diagnosis: Results and Recommendations for Future Research

“…Most studies were conducted in the United States (60.3%, n =79; e.g., (74, 99, 101, 114, 134)), with the next most common study locations being in Canada (7.6%, n =10; (30, 38, 39, 44, 65, 84, 97, 104, 147, 148)) and France (4.6%, n =6; (32, 37, 100, 108, 113, 146)). Most papers described cross-sectional studies (75.6%, n =99), but some described longitudinal studies (24.4%, n =32) (10, 35, 38, 42, 45, 46, 52-54, 56, 62, 65, 69, 73, 75, 76, 80, 84, 89, 90, 98, 100, 103, 104, 118, 121, 123, 126, 129, 135, 149, 152). For the longitudinal studies, the number of tobacco use assessments ranged from two (e.g., (42, 100, 123)) to ≥ 5 (e.g., (69, 103, 121)); the number of assessments was sometimes unclear (e.g., (35, 118, 152)).…”

“…However, half ( n =16) of these papers reported data such that participants were either continuing smokers or not (35, 38, 45, 46, 56, 69, 75, 89, 90, 98, 100, 103, 118, 123, 126, 152). For this sub-group of longitudinal studies, the prevalence of smoking after lung or head/neck cancer diagnosis ranged from 8.2% (126) to 60.0% (75), with a mean of 30.5% ( SD =15.0; median=26.8%).…”

“…Likewise, information on post-cancer diagnosis quit attempts, continuous abstinence, and/or tobacco cessation treatment use was omitted from all but a handful of papers (35, 39, 42, 44, 51-54, 56, 60, 73, 75, 80, 82, 83, 87, 90, 97, 103, 112, 129). Given limited data, we chose not to aggregate findings across studies.…”

“…Ns denote number of studies in the analysis for Full Sample/Current Smokers at Cancer Diagnosis. Full Sample: 0-3 includes data from (4, 10, 34, 40, 42, 54, 63, 73, 80, 84, 110, 127, 132, 134, 135, 143, 145, 147, 154); 4-6 includes data from (51, 131, 153); 7-11 includes data from (49, 133); 12-59 includes data from (59, 79, 85, 86, 88, 91, 97, 100, 141, 152); 60+ includes data from (67, 70, 128); and Mixed includes data from (5, 29-31, 46, 52, 56, 62, 69, 90, 94, 95, 98, 103, 112, 115, 120-122, 125, 126, 130, 138). Current Smokers at Cancer Diagnosis: 0-3 includes data from (4, 34, 39, 40, 80, 82, 84, 110, 143, 149); 4-6 includes data from (76, 153); 7-11 includes data from (123); 12-59 includes data from (36, 97); 60+ includes data from (128); and Mixed includes data from (5, 35, 44, 46, 56, 112, 115, 125, 129, 138).…”

“…Ns denote number of studies in the analysis for Full Sample/Current Smokers at Cancer Diagnosis. Full Sample: Before Treatment includes data from (4, 10, 28, 32, 43, 45, 57, 59, 63-65, 68, 73, 74, 84, 99, 101, 102, 106, 108, 109, 111, 114, 127, 132, 134, 143, 148, 151, 154); During Treatment includes data from (34, 40, 75, 104, 110, 118, 121, 133, 145-147, 152) (33, 37, 38, 50, 78, 107, 124, 139, 150); After Treatment includes data from (29, 30, 49, 53, 58-60, 67, 69, 70, 79, 85-87, 89, 92, 97, 98, 100, 103, 105, 119, 122, 128, 138, 141); and Mixed includes data from (5, 41, 42, 46, 47, 52, 55, 61, 62, 73, 77, 80, 83, 90, 91, 93, 94, 96, 115, …”