Rethinking the 10-pack-year rule for favorable human papillomavirus-associated oropharynx carcinoma: A multi-institution analysis.
James R BroughmanDavid D XiongBenjamin J MoellerKevin J ContreraBrandon L PrendesEric D LamarreJamie A KuBrian B BurkeyNeil M WoodyNikhil P JoshiDavid J AdelsteinJessica L GeigerCatherine H FrenkelZvonimir L MilasDaniel S BrickmanAshley L SumrallDaniel R CarrizosaJohn F GreskovichShlomo A KoyfmanMatthew C WardPublished in: Cancer (2020)
The 10-pack-year rule may not apply to all early HPV+ OPCs, particularly for former smokers. Future randomized de-intensification trials should consider a broader and more nuanced approach until the predictive role of smoking status is established.