Head and neck squamous cell carcinoma in cigar smokers. Distinctive epidemiological and prognostic characteristics

The objective of this study is to assess the existence of differences in the epidemiological characteristics and prognosis of patients with head and neck squamous cell carcinoma (HNSCC) who smoke cigars.

We carried out a retrospective study of a cohort of 4500 patients with HNSCC treated during the period 1985-2017.

The proportion of cigar smokers was 2.4%, compared with 88.3% of cigarette smokers and 9.3% of non-smokers. There was an increase in the proportion of cigar smokers throughout the study period. With respect to cigarette smokers, cigar smokers had a higher proportion of male patients, a higher average age at diagnosis, and they had a higher frequency of tumours located in the oral cavity and hypopharynx. The results of a univariate analysis showed that the disease-specific survival of cigar smokers was lower than that of the other patients. Five-year disease-specific survival of cigar smokers was 60.9%, compared to 69.0% for non-smokers, 72.8% for smokers of less than 20 cigarettes/day, and 67.2% for smokers of more than 20 cigarettes/day. There were differences in the pattern of survival depending on tobacco consumption based on the location of the primary tumour.

A 2.4% of patients with HNSCC had a history of regular consumption of cigars. Disease-specific survival of cigar smokers was lower than that of other patients.