Oropharyngeal cancers constitute a significant burden on the health system. It accounts for a considerable proportion of head and neck cancers and carries substantial challenges in terms of diagnosis, treatment and long-term prognosis.
Smoking status is a known prognostic factor in patients with head and neck malignancies.
The impact of alcohol consumption on disease control in patients with oropharyngeal cancers is comparably less well defined.
Our aim was to delineate the impact of alcohol intake on locoregional disease control and overall survival following definitive radiotherapy.
Methods and materials
Retrospective review of consecutive patients with oropharyngeal cancers treated with definitive radiotherapy, with or without systemic therapy at two tertiary institutions over a 10-year period from 2010 to 2020 was conducted.
Inclusion criteria: Oropharynx subsite, histological diagnosis of squamous cell carcinoma, no previous definitive therapy to the head and neck region.
Patients with metastatic disease at the time of diagnosis were excluded from analysis.
Alcohol consumption defined as 4 separate categories: nil, light (≤ standard drinks/day), heavy (>3 standard drinks/day) and previous heavy.
513 patients were included
Median follow up was 39 months
Majority (78.6%) of patients had locally advanced disease (Stage IV as per AJCC 7th edition).
64.1% of patients were p16 positive and 20.7% p16 negative. P16 status was unknown in 15.2% of patients.
For the entire cohort, 3-year locoregional recurrence free survival was 85.8%, 3-year distant metastases recurrence free survival was 87.0% and 3-year overall survival was 81.7%.
3-year locoregional recurrence disease free survival for patients with nil, light, heavy and former heavy alcohol consumption...
Alcohol consumption had a significant impact on locoregional recurrence and overall survival.
There may be merit in utilization of alcohol consumption data for risk stratification of oropharyngeal cancer patients treated with radiotherapy in the future.
Abrahão R, Perdomo S, Pinto LFR, et al. Predictors of Survival After Head and Neck Squamous Cell Carcinoma in South America: The InterCHANGE Study. JCO Glob Oncol. [Internet]. 2020. [cited 2023 Jan 10]; 6:486-499. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7113075/
Hashibe M, Brennan P, Chuang SC, et al. Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomarkers Prev. [Internet] 2009 [cited 2023 Jan 10];18(2):541-550. Available from: https://pubmed.ncbi.nlm.nih.gov/19190158/.