{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T22:56:32Z","timestamp":1769208992861,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"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":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The current classification of tongue cancers does not discriminate stages based on factors of local spread.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>Integrating factors of local spread that impact disease\u2010specific survival (DSS) in a modified classification to improve prognostication compared with the current staging.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This was a retrospective analysis of 399 previously untreated oral tongue squamous carcinomas operated between 2016 and 2018. Factors related to the local extent of a primary tumor that impacted the DSS were studied. Multivariable analyses adjusted for pT, pN stage, and adjuvant therapy. Candidate staging systems were developed based on factors that significantly impacted DSS, and validated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Result<\/jats:title><jats:p>Base tongue involvement (<jats:italic>p<\/jats:italic>\u2009=\u20090.021), DOI &gt;\u200920\u2009mm (<jats:italic>p<\/jats:italic> value\u2009=\u20090.040), and tumor crossing the midline (<jats:italic>p<\/jats:italic> value\u2009=\u20090.047) significantly impacted the DSS. The preferred model included base tongue involvement in T3 stage, and DOI &gt;\u200920\u2009mm and tumor crossing the midline into T4 stage (Model 2), which was superior to the current classification system in AIC (830.55 vs. 845.43), C\u2010index (0.65 vs. 0.61), and visual inspection of Kaplan\u2013Meier curves.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Identifying and possibly including these clinical factors in addition to the current T\u2010stage criteria could result in better prognostication of tongue cancers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>Integration of proposed classification could improve the discrimination between stages.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hed.28072","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T07:10:33Z","timestamp":1737011433000},"page":"1497-1503","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Local Extent of Tumor on the Survival Outcomes for Surgically Treated Tongue Cancers"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8119-8439","authenticated-orcid":false,"given":"Arjun Gurmeet","family":"Singh","sequence":"first","affiliation":[{"name":"Head and Neck Oncology Department Tata Memorial Hospital and HBNI  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3369-3870","authenticated-orcid":false,"given":"Shwetabh","family":"Sinha","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Tata Memorial Hospital and HBNI  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rathan","family":"Shetty","sequence":"additional","affiliation":[{"name":"Head and Neck Oncology Department Tata Memorial Hospital and HBNI  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poonam","family":"Joshi","sequence":"additional","affiliation":[{"name":"Head and Neck Oncology Department Tata Memorial Hospital and HBNI  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4977-3779","authenticated-orcid":false,"given":"Sudhir Vasudevan","family":"Nair","sequence":"additional","affiliation":[{"name":"Head and Neck Oncology Department Tata Memorial Hospital and HBNI  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pankaj","family":"Chaturvedi","sequence":"additional","affiliation":[{"name":"Head and Neck Oncology Department Tata Memorial Hospital and HBNI  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21492"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034519894963"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21388"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27490"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19980415)82:8<1443::AID-CNCR2>3.0.CO;2-A"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.10094"},{"key":"e_1_2_8_8_1","unstructured":"AJCC \u201cAJCC \u2013 Cancer Staging Form Supplement [Internet] \u201d(2021) https:\/\/cancerstaging.org\/references\u2010tools\/deskreferences\/Pages\/Cancer\u2010Staging\u2010Forms.aspx."},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1054\/jcms.1999.0070"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-019-07576-5"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/COC.0b013e3182195619"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0347(199903)21:2<104::AID-HED2>3.0.CO;2-L"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2007.01.008"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2014.09.012"},{"issue":"3","key":"e_1_2_8_15_1","first-page":"1","article-title":"Depth of Invasion for Prognostic Stratification in Oral Cavity Cancer: Do We Need Further Validation?","volume":"7","author":"Piazza C.","year":"2019","journal-title":"Annals of Translational Medicine"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20423"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28195"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-64748-0"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.616653"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-010-1174-1"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc2982-c1"}],"container-title":["Head &amp; 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