Evaluating the impact of smoking on disease‐specific survival outcomes in patients with human papillomavirus–associated oropharyngeal cancer treated with transoral robotic surgery

Background When treated nonsurgically with definitive chemoradiation, smokers with human papillomavirus (HPV)–positive oropharyngeal squamous cell carcinoma (OPSCC) have a worse prognosis compared with their nonsmoking counterparts. To the authors' knowledge, the prognostic significance of smoking in surgically treated patients is unknown. Methods The current study is a retrospective case series of patients with HPV‐positive OPSCC who underwent upfront transoral robotic surgery at a single institution from 2010 through 2017. Exclusion criteria were nonoropharyngeal primary tumors, histology other than SCC, HPV‐negative tumors, previous history of head and neck cancer, and/or previous head and neck radiotherapy. Recurrence‐free survival (RFS), overall survival, and disease‐specific survival were compared using the Kaplan‐Meier method and the log‐rank test. Smoking history was categorized as never smokers (