{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T01:16:55Z","timestamp":1777339015426,"version":"3.51.4"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T00:00:00Z","timestamp":1607558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although pathologic tumor grade is a well\u2010established prognostic risk factor that impacts staging and treatment decisions across multiple cancer types, its role in head and neck squamous cell carcinoma (HNSCC) is less certain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>HNSCC patients diagnosed from 2010 to 2015 and undergoing primary surgery in the National Cancer Data Base were identified. Propensity score matching and multivariable Cox regression were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 27\u2009041 HNSCC patients, 13\u2009941 had oral cavity cancers (OCC). Intermediate\u2010grade (hazard ratio [HR] 1.16, 95% CI 1.07\u20101.26, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and high\u2010grade (HR 1.38, 95% CI 1.26\u20101.52, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) tumors had worse survival than low\u2010grade tumors. This magnitude was comparable to other well\u2010established prognostic factors, including margin positivity, extranodal extension, and lymphovascular invasion. By contrast, there was no association between grade and survival in larynx\/hypopharynx or HPV(\u2212) oropharynx cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The prognostic impact of pathologic grade is highly variable across head and neck subsites and is the strongest among OCC patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.26566","type":"journal-article","created":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:31:11Z","timestamp":1607646671000},"page":"1105-1115","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Variations in the association of grade with survival across the head and neck cancer landscape"],"prefix":"10.1002","volume":"43","author":[{"given":"Eric M.","family":"Anderson","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Luu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bonnie L.","family":"Balzer","sequence":"additional","affiliation":[{"name":"Department of Pathology Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin S.","family":"Scher","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Department of Medical Oncology Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Tower Hematology Oncology Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain C.","family":"Mita","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Department of Medical Oncology Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana J.","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen L.","family":"Shiao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2558-4682","authenticated-orcid":false,"given":"Jon Mallen\u2010St.","family":"Clair","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5423-509X","authenticated-orcid":false,"given":"Allen S.","family":"Ho","sequence":"additional","affiliation":[{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Department of Surgery, Division of Otolaryngology\u2010Head and Neck Surgery Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7484-3631","authenticated-orcid":false,"given":"Zachary S.","family":"Zumsteg","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Cedars\u2010Sinai Medical Center  Los Angeles California USA"},{"name":"Samuel Oschin Comprehensive Cancer Institute, Cedars\u2010Sinai Medical Center  Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,12,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.21873\/anticanres.13158"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12105-014-0547-3"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24507"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181d95c37"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.pas.0000149687.90710.21"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19860215)57:4<711::AID-CNCR2820570405>3.0.CO;2-C"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19890415)63:8<1487::AID-CNCR2820630806>3.0.CO;2-4"},{"key":"e_1_2_8_9_1","first-page":"1","article-title":"Degree of tumour differentiation as a prognostic factor in advanced laryngeal cancer","volume":"49","author":"Geelen CP","year":"1995","journal-title":"Acta Otorhinolaryngol Belg"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21129"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.25506"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24357"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2559.1991.tb00230.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.12727"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.2880130603"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.02.001"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature14129"},{"key":"e_1_2_8_18_1","volume-title":"WHO Classification of Head and Neck Tumours","author":"Adel K","year":"2017"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v045.i03"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-19425-7"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/biomet\/81.3.515"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.26566","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hed.26566","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.26566","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T12:21:18Z","timestamp":1693311678000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.26566"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,10]]},"references-count":20,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1002\/hed.26566"],"URL":"https:\/\/doi.org\/10.1002\/hed.26566","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,10]]},"assertion":[{"value":"2020-08-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-11-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-12-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}