Understanding Interactions of Smoking on Prognosis of HPV-Associated Oropharyngeal Cancers

Adv Ther. 2018 Mar;35(3):255-260. doi: 10.1007/s12325-018-0682-4. Epub 2018 Mar 6.


The new 8th edition AJCC/UICC staging system for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC), developed to account for improved survival outcomes over HPV-negative cancers, includes anatomic features strictly associated with tumor-node-metastasis (TNM) and does not account for patient-specific characteristics that may impact prognosis. This commentary evaluates the evidence of smoking as an adverse prognostic factor in HPV-associated OPSCC. We review the multifactorial biological, clinical, and social/behavioral characteristics of smokers with OPSCC that impact outcomes, discuss current challenges with incorporating smoking history in prognostic classifications, and consider opportunities for future investigation.

Keywords: HPV; Head and neck cancer; Oncology; Oropharyngeal cancer; Smoking; Squamous cell carcinoma; Staging system; Survival outcomes; Tobacco carcinogens.

Publication types

  • Letter

MeSH terms

  • Carcinoma, Squamous Cell* / epidemiology
  • Carcinoma, Squamous Cell* / pathology
  • Carcinoma, Squamous Cell* / virology
  • Causality
  • Comorbidity
  • Humans
  • Neoplasm Staging
  • Oropharyngeal Neoplasms* / epidemiology
  • Oropharyngeal Neoplasms* / pathology
  • Oropharyngeal Neoplasms* / virology
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / epidemiology*
  • Prognosis
  • Risk Assessment / methods*
  • Risk Factors
  • Smoking* / adverse effects
  • Smoking* / epidemiology
  • Smoking* / physiopathology