Positive Effect of Surgery Regardless of Stage on Oropharynx Subsites Base of Tongue and Tonsillar-Fossa: A SEER Analysis

(OPSCC) undergoing definitive concurrent chemoradiation (CCRT) remains unclear. The purpose of this review was to examine these effects on survival outcomes among a single institute population. Materials/Methods: This retrospective review of OPSCC patients treated with CCRT between 2008 and 2015 was conducted. All tumors were examined for HPV 16/18 status (+/). Smoking status and other clinical characteristics were abstracted from the electronic medical record. Former smokers are patients who quit within a month of diagnosis or treatment. Descriptive summaries, overall survival (OS), and multivariate cox proportional hazard ratios (HR) were completed. Results: Out of 134 patients, 94 patients (71%) had HPV-positive (HPV+) tumors. Age, gender, and overall stage were not statistically different between patients with HPV+ or HPV-negative (HPV-) tumors. HPV+ patients had higher tumor grade (P<.01). Patients with HPV+ tumors had a higher percentage of never smokers than patients with HPVtumors (10.3% vs 26.6%). Median pack-years were 18 for the HPV+ group versus 30 for the HPVgroup. OS did not differ for HPV+ versus HPVpatients. Within HPV+ patients, current and former smokers had significantly worse OS than never smokers (P<.01). The same was true for HPVpatients, but the log-rank test for this group did not reach statistical significance (PZ.06). The 3-year survival rate for former smokers in each group was similar (HPV+: 0.77 (0.60, 0.88) and HPV-: 0.75 (0.52, 0.88). Hazard ratios for OS among current smokers compared to never/former smokers in each patient group were statistically significantly higher. Conclusion: Current smoking is associated with poor prognosis, independent of HPV status in OPSCC patients treated with CCRT. Former smokers have similar outcomes irrespective of HPV tumor status. The amount of tobacco a patient is exposed to before diagnosis cannot be altered, but every effort should be made to get patients to quit smoking as soon as possible before CCRT regardless of HPV status. Author Disclosure: A. Platek: None. V. Jakaprakash: None. M. Platek: None. V. Gupta: None. D. Cohan: None. W. Hicks: None. T. Winslow: None. A. Groman: None. S.S. Dibaj: None. H. Arshad: None. M.A. Kuriakose: None. G.W. Warren: None. A.K. Singh: None.