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Saturday, October 28, 2023

Tobacco Cessation Following Laryngeal Cancer Diagnosis Predicts Response to Treatment and Laryngectomy-Free Survival

Krutz and colleagues from the University of Oklahoma Health Sciences Center studied the effect of tobacco cessation following laryngealcancer diagnosis on response to first-line therapy, laryngectomy-free survival, and overall survival in patients who were current smokers at the time of diagnosis.

The authors evaluated 140 patients diagnosed with laryngeal squamous cell carcinoma, who were smokers at the time of diagnosis, and were treated with first-line definitive radiation or chemo/radiation with the intent to cure.

Of the 140 current smokers, 61 patients (45%) quit smoking prior to treatment initiation. Smoking, quitters had 3.7 times higher odds of achieving a complete response to first-line therapy than active smokers (odds ratio: 3.694 [1.575-8.661]; P = .003).  Quitters were 54% less likely to require salvage laryngectomy within 7 years of diagnosis than active smokers (hazard ratio: 0.456 [0.246-0.848]; P = .013). Quitters had a statistically significant increase in 7-year overall survival compared to active smokers (P = .02).

This is the first study to show that in newly diagnosed laryngeal cancer patients who are current smokers at the time of diagnosis, tobacco cessation significantly increases therapy response, laryngectomy-free survival, and overall survival. These data stress the importance of systematically incorporating tobacco cessation programs into laryngeal cancer treatment plans.