{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T03:12:10Z","timestamp":1790478730577,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["BMRPC55"],"award-info":[{"award-number":["BMRPC55"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005795","name":"Chang Gung Memorial Hospital, Linkou","doi-asserted-by":"publisher","award":["CMRPD1H0521"],"award-info":[{"award-number":["CMRPD1H0521"]}],"id":[{"id":"10.13039\/501100005795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>To compare the clinical outcomes of two treatment modalities, initial surgery and primary definitive radiotherapy (RT), in Taiwanese patients diagnosed with cT1\u22122N0M0 oral cavity squamous cell carcinoma (OCSCC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between 2011 and 2019, we analyzed data for 13,542 cT1\u22122N0M0 patients who underwent initial surgery (<jats:italic>n<\/jats:italic>\u2009=\u200913,542) or definitive RT with a dosage of at least 6600\u2009cGy (<jats:italic>n<\/jats:italic>\u2009=\u2009145) for the treatment of OCSCC. To account for baseline differences, we employed propensity score (PS) matching, resulting in two well\u2010balanced study groups (initial surgery, <jats:italic>n<\/jats:italic>\u2009=\u2009580; definitive RT, <jats:italic>n<\/jats:italic>\u2009=\u2009145).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Before PS matching, the 5\u2010year disease\u2010specific survival (DSS) rates were 88% for the surgery group and 58% for the RT group. After PS matching, the 5\u2010year DSS rates of the two groups were 86% and 58%, respectively. Similarly, the 5\u2010year overall survival (OS) rates before PS matching were 80% for the surgery group and 36% for the RT group, whereas after PS matching, they were 73% and 36%, respectively. All these differences were statistically significant (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001). A multivariable analysis identified treatment with RT, older age, stage II tumors, and a higher burden of comorbidities as independent risk factors for both DSS and OS. We also examined the 5\u2010year outcomes for various subgroups (margin \u22655\u2009mm, margin &lt;5\u2009mm, positive margins, RT combined with chemotherapy, and RT alone) as follows: DSS, 89%\/88%\/79%\/63%\/51%, respectively, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001; OS, 82%\/79%\/68%\/39%\/32%, respectively, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In Taiwanese patients with cT1\u22122N0M0 OCSCC, a remarkably low proportion (1.1%) completed definitive RT. A significant survival disparity of 30% was observed between patients who underwent initial surgery and those who received definitive RT. Interestingly, even patients from the surgical group with positive surgical margins exhibited a significantly superior survival compared to those in the definitive RT group.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.7127","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T07:35:53Z","timestamp":1716276953000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparing the clinical outcomes of initial surgery and primary definitive radiotherapy with a dosage of 6600\u2009<scp>cGy<\/scp> or higher in <scp>cT1<\/scp>\u2212<scp>2N0M0<\/scp> oral cavity squamous cell carcinoma: A nationwide cohort study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0972-9397","authenticated-orcid":false,"given":"Chien\u2010Yu","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen\u2010Cheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Wen","family":"Wen","sequence":"additional","affiliation":[{"name":"Clinical Informatics and Medical Statistics Research Center Chang Gung University  Taoyuan Taiwan, ROC"},{"name":"Division of Thoracic Surgery Chang Gung Memorial Hospital  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kang\u2010Hsing","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin\u2010Ching","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Changhua Christian Hospital  Changhua Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu\u2010Hang","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao\u2010Te","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2010Head and Neck Surgery Chang Gung Memorial Hospital  Chiayi Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu\u2010Ru","family":"Lee","sequence":"additional","affiliation":[{"name":"Research Service Center for Health Information Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5333-9396","authenticated-orcid":false,"given":"Chung\u2010Jan","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li\u2010Yu","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pathology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Yen","family":"Chien","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Chang Gung Memorial Hospital Kaohsiung Medical Center Chang Gung University College of Medicine  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun\u2010Hung","family":"Hua","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology China Medical University Hospital  Taichung Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng Ping","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology National Taiwan University Hospital and College of Medicine  Taipei Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsung\u2010Ming","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Shuang Ho Hospital Taipei Medical University  New Taipei City Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shyuang\u2010Der","family":"Terng","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery Koo Foundation Sun Yat\u2010Sen Cancer Center  Taipei Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi\u2010Ying","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Chang Gung Memorial Hospital Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung\u2010Ming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5547-409X","authenticated-orcid":false,"given":"Chia\u2010Hsun","family":"Hsieh","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6988-8739","authenticated-orcid":false,"given":"Chih\u2010Hua","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Hung","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung\u2010Kan","family":"Tsao","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nai\u2010Ming","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine and Molecular Imaging Center Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tuan\u2010Jen","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiang\u2010Fu","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8414-595X","authenticated-orcid":false,"given":"Li\u2010Ang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ku\u2010Hao","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, ROC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Chien","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Chang Gung Memorial Hospital and Chang Gung University  Taoyuan Taiwan, 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