Oral cavity squamous cell carcinoma in never smokers: Analysis of clinicopathologic characteristics and survival

Purpose To examine the relationship between tobacco smoking history and the clinicopathologic and survival characteristics of patients with oral cavity squamous cell carcinoma (OCSCC). Materials and methods This is a retrospective review of 531 patients treated for OCSCC from January 1998 to December 2009 at a tertiary care medical center. Results Thirty-two percent of OCSCC patients were never smokers. There were significant differences in tumor location between ever smokers and never smokers (p < 0.001), with never smokers more likely to have oral tongue tumors. Smokers were significantly (p < 0.001) more likely than never smokers to present with locally advanced (T3 or T4) disease (57.8% vs. 35.4%). Never smokers demonstrated improved overall survival (78.8 months in never smokers vs. 44.7 months in ever smokers, p =.03). However, there were no survival differences when the two groups were compared separately for locally early (T1/T2) or advanced (T3/T4) disease. For T1/T2 tumors, mean survival was 88.2 months for never smokers and 78.5 months for smokers (p =.10). For T3/T4 tumors, median survival was 29.1 months for never smokers and 23.8 months for smokers (p =.09). Conclusions Primary tumor location and T-status in OCSCC differed between never smokers and smokers. Compared to smokers, never smokers had fewer locally advanced tumors and better overall survival.