{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T11:21:53Z","timestamp":1780053713482,"version":"3.54.0"},"reference-count":54,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp;amp; Neck"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the impact of age and presence of traditional risk factors (smoking and drinking) on survival outcomes in a large cohort of patients with oral cavity squamous cell carcinoma (OCSCC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a single\u2010center, retrospective review from 2012 to 2019. Patients were divided by age (\u2264\u200940 vs. &gt;\u200940\u2009years old) and whether they had significant tobacco and\/or alcohol use history. Univariate and multivariate analyses were conducted to compare overall and disease\u2010specific survival between the four groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      There were 630 patients, and median follow\u2010up was 52.5\u2009months. Young, nonsmoker\u2013nondrinker (NSND) patients (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u200917) were more likely to be women with higher BMI, fewer medical comorbidities, primary tumors located on the oral tongue, and lower depth of invasion compared to older smoker\u2010drinker (SD) counterparts. Young patients were more likely to receive adjuvant chemoradiation compared to those &gt;\u200940\u2009years old (38% vs. 18%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.007). Age\/smoking\u2010drinking history was not significantly associated with disease\u2010free survival or overall survival. On multivariate analysis, the following variables were associated with worse disease\u2010free survival: higher N stage (N1 vs. N0 HR 2.46 [95% CI 1.46\u20134.17],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; N2 vs. N0 HR 3.55 [2.25\u20135.59],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001; N3 vs. N0 HR 2.94 [1.76\u20134.91],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and diagnosis of hypothyroidism (HR 2.25 [1.56\u20133.24],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). On multivariate analysis, the following were associated with worse overall survival: lower BMI (HR 1.48 [1.11\u20131.99],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), heart failure (2.60 [1.68\u20134.02],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), COPD (1.38 [1.05, 1.82],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.021), perineural invasion (1.60 [1.23, 2.08],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and N\u2010stage (N2 vs. N0 1.45 [1.05, 2.01],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.025 and N3 vs. N0 2.27 [1.56\u20133.13],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite higher rates of adjuvant chemoradiation and lower rates of comorbidities, young patients with no tobacco or alcohol history had comparable disease\u2010free and overall survival compared to patients with traditional risk factors, including advanced age and tobacco and alcohol consumption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.28260","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T07:41:03Z","timestamp":1753688463000},"page":"3401-3413","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Survival Outcomes in Young Nonsmoking\u2013Nondrinking Individuals With Oral Cavity Squamous Cell Carcinoma"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2461-2904","authenticated-orcid":false,"given":"Ryan T.","family":"Judd","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at the Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shruthi","family":"Sethuraman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at the Ohio State University Wexner Medical Center  Columbus Ohio USA"},{"name":"Department of Internal Medicine University of Pittsburgh  Pittsburgh Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3366-886X","authenticated-orcid":false,"given":"Fahad","family":"Rind","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at the Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Songzhu","family":"Zhao","sequence":"additional","affiliation":[{"name":"Center for Biostatistics The Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah C.","family":"Nyirjesy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Arthur G. James Cancer Hospital and Richard J. Solove Research Institute at the Ohio State University Wexner Medical Center  Columbus Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7948-1473","authenticated-orcid":false,"given":"Taylor","family":"Freeman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Arthur G. James Cancer Hospital and Richard J. 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