{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T00:25:42Z","timestamp":1790727942483,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T00:00:00Z","timestamp":1671148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA211939\u201001A1"],"award-info":[{"award-number":["R01CA211939\u201001A1"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["TL1TR002344"],"award-info":[{"award-number":["TL1TR002344"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000096","name":"National Center on Minority Health and Health Disparities","doi-asserted-by":"publisher","award":["K01MD013897"],"award-info":[{"award-number":["K01MD013897"]}],"id":[{"id":"10.13039\/100000096","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["5 T35 HL007815"],"award-info":[{"award-number":["5 T35 HL007815"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["T32DC000022"],"award-info":[{"award-number":["T32DC000022"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although strongly associated with tobacco and alcohol use, many oral cavity squamous cell carcinoma (OCSCC) cases occur in patients without exposure to either, known as \u201cnever\u2010smoker, never\u2010drinkers\u201d (NSND). We aimed to compare clinical outcomes between NSND and tobacco\/alcohol\u2010exposed populations and to define demographic characteristics of NSND.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective, single\u2010institution cohort study of 672 OCSCC patients. Cox models were used to estimate differences in overall survival (OS) and recurrence\u2010free survival (RFS) between NSND and tobacco\/alcohol\u2010exposed patients while adjusting for confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>NSND represented 25.6% of our cohort and were older, more female, and more economically advantaged. Among NSND, oral tongue tumors dominated in younger patients, while alveolar ridge tumors dominated in elderly patients. Multivariate survival analysis revealed no differences in OS or RFS between NSND and tobacco\/alcohol\u2010exposed patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>When adjusted for independent biologic features, clinical outcomes in OCSCC are similar between NSND and tobacco\/alcohol\u2010exposed patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.27266","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T12:59:27Z","timestamp":1671195567000},"page":"567-577","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["No survival benefit in never\u2010smoker never\u2010drinker patients with oral cavity cancer"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9619-1256","authenticated-orcid":false,"given":"Emily Z.","family":"Yan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin M.","family":"Wahle","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik R.","family":"Nakken","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5650-8821","authenticated-orcid":false,"given":"Smrithi","family":"Chidambaram","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Washington University School of Medicine  St. Louis Missouri USA"},{"name":"Saint Louis University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayla","family":"Getz","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Department of Surgery Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2757-0543","authenticated-orcid":false,"given":"Wade L.","family":"Thorstad","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9111-6767","authenticated-orcid":false,"given":"Jose P.","family":"Zevallos","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela L.","family":"Mazul","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Washington University School of Medicine  St. Louis Missouri USA"},{"name":"Division of Public Health Sciences, Department of Surgery Washington University School of Medicine  St. Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6915a1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201008\u20100347"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc1190"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc2191"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20664"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2018.09.004"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/JOURNAL.PONE.0232138"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537\u2010199910000\u201000002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2013.01.017"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2020.104875"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.IJROBP.2008.09.021"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.12476"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.21220"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.31.7883"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.23807"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.26099"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1245\/ASO.2003.09.010"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601\u20100825.2006.01274.x"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2013.04.010"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/HED.24589"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.EJCA.2017.05.026"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/CNCR.20998"},{"key":"e_1_2_8_24_1","unstructured":"Drinking Too Much Alcohol Can Harm Your Health. Learn the Facts. CDC. Accessed June 4 2022.https:\/\/www.cdc.gov\/alcohol\/fact-sheets\/alcohol-use.htm"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10654\u2010019\u201000494\u20106"},{"key":"e_1_2_8_26_1","unstructured":"USDA ERS\u2014Rural\u2013Urban Commuting Area Codes. Accessed April 30 2021.https:\/\/www.ers.usda.gov\/data-products\/rural-urban-commuting-area-codes.aspx"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1056\/nejmp1802313"},{"key":"e_1_2_8_28_1","unstructured":"TherneauTM.A Package for Survival Analysis in R. Published online 2020. Accessed June 4 2021.https:\/\/cran.r-project.org\/web\/packages\/survival\/"},{"key":"e_1_2_8_29_1","unstructured":"KassambaraA KosinskiM BiecekP FabianS.survminer: Drawing Survival Curves using \u201cggplot2\u201d. Published online2020. Accessed June 4 2021.https:\/\/cran.r-project.org\/web\/packages\/survminer"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ORALONCOLOGY.2010.11.003"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx486"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdx210"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078\u20100432.CCR\u201014\u20100565"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.ORALONCOLOGY.2012.07.002"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/ARCHOTOL.1995.01890020019005"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1368\u20108375(00)00135\u20104"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.3390\/CANCERS12071893"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537\u2010199305000\u201000005"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1368\u20108375(00)00007\u20105"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1590\/0103\u20106440201600754"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034519827565"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0B013E31823B6296"}],"container-title":["Head &amp; Neck"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.27266","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hed.27266","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hed.27266","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T23:12:08Z","timestamp":1692573128000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hed.27266"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,16]]},"references-count":41,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1002\/hed.27266"],"URL":"https:\/\/doi.org\/10.1002\/hed.27266","archive":["Portico"],"relation":{},"ISSN":["1043-3074","1097-0347"],"issn-type":[{"value":"1043-3074","type":"print"},{"value":"1097-0347","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,16]]},"assertion":[{"value":"2022-07-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-11-28","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}