{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:03:22Z","timestamp":1790247802401,"version":"4.1.0"},"reference-count":53,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T00:00:00Z","timestamp":1750723200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To enhance survival outcomes for oral cavity cancer (OCC) surgery, a composite measure has been developed: \u201ctextbook outcome\u201d (TO). Three studies have reported on this concept in OCC, but the need for population\u2010level results remains. This study investigates OCC surgery, focusing on survival and hospital\u2010level results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>National multicenter study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All first primary OCC patients who underwent curative tumor resection between 2018 and 2021 were selected from the Dutch Head and Neck Audit database. Resections were categorized as local or extensive, the latter including neck dissection and\/or free or pedicled flap reconstruction. TO was defined as the absence of 30\u2010day mortality, hospital readmission, prolonged length\u2010of\u2010stay, severe complications, surgical margins &lt;1\u2009mm, and &lt;18 lymph nodes per side. Adjusted hazard ratios (aHRs) were determined for 2\u2010year overall survival (OS) and disease\u2010free survival (DFS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      TO was reached in 81.1% and 46.9% after local (1039 patients) and extensive (1227 patients) resection, respectively. Reduced TO rates were observed in females, non\u2010squamous cell carcinoma, cT3\u2010T4, and floor of mouth compared to tongue. Obtaining TO was significantly associated with less adjuvant therapy and improved 2\u2010year survival after local (aHR 0.55 OS\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.004, 0.70 DFS\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.085) and extensive (aHR 0.61 OS\n                      <jats:italic>P<\/jats:italic>\n                      \u2009\u2264\u2009.001, 0.69 DFS\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.002) surgery. After correction for population differences, no interhospital variation in TO remained.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Achieving TO is strongly linked to improved survival, highlighting its importance as a short\u2010term composite quality\u2010of\u2010care indicator. The separate outcomes that were influential to the hospital's TO score differed between hospitals, indicating opportunities to improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ohn.1337","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T07:30:00Z","timestamp":1750750200000},"page":"1158-1169","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Textbook Outcome After Oral Cancer Surgery as a Composite Measure for Survival and Quality\u2010of\u2010Care Evaluation"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6858-3984","authenticated-orcid":false,"given":"Hanneke Doremiek","family":"van Oorschot","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Erasmus Medical Centre Cancer Institute Rotterdam The Netherlands"},{"name":"Scientific Bureau Dutch Institute for Clinical Auditing Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8159-0089","authenticated-orcid":false,"given":"Dominique Valerie Clarence","family":"de Jel","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\/Head and Neck Surgery, University Medical Centre Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5580-5613","authenticated-orcid":false,"given":"Jose Angelito","family":"Hardillo","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery Erasmus Medical Centre Cancer Institute Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J. J.","family":"van Es","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgical Oncology UMC Utrecht Cancer Centre Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guido B.","family":"van den Broek","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4784-0499","authenticated-orcid":false,"given":"Robert Paul","family":"Takes","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Radboud University Medical Center Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2460-2260","authenticated-orcid":false,"given":"Gyorgy Bela","family":"Halmos","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\/Head and Neck Surgery, University Medical Centre Groningen University of Groningen Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Dirven","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Oncology and Surgery Netherlands Cancer Institute\/Antoni van Leeuwenhoek Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2868-4822","authenticated-orcid":false,"given":"Martin","family":"Lacko","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery GROW School for Oncology and Reproduction, Maastricht University Medical Center Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1408-6146","authenticated-orcid":false,"given":"Lauretta Anna Alexandra","family":"Vaassen","sequence":"additional","affiliation":[{"name":"Department of Cranio\u2010Maxillofacial Surgery GROW School for Oncology and Reproduction, Maastricht University Medical Center Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan\u2010Jaap","family":"Hendrickx","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, Academic Medical Center University of Amsterdam Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1526-559X","authenticated-orcid":false,"given":"Marjolijn Abigal Eva\u2010Maria","family":"Oomens","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Rijnstate Hospital Arnhem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8013-9138","authenticated-orcid":false,"given":"Hossein","family":"Ghaeminia","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Rijnstate Hospital Arnhem The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3955-0152","authenticated-orcid":false,"given":"Jeroen C.","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery Leiden University Medical Centre Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6702-4360","authenticated-orcid":false,"given":"Annemarie","family":"Vesseur","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Elisabeth Tweesteden Ziekenhuis Tilburg Tilburg The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolf","family":"Bun","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery\/Head and Neck Oncology Noordwest Hospital Group Alkmaar en Dijklander Hospital Hoorn The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonora Q.","family":"Schwandt","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Medical Centre Leeuwarden Leeuwarden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christiaan A.","family":"Krabbe","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Medical Centre Leeuwarden Leeuwarden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3597-4334","authenticated-orcid":false,"given":"Thomas J. 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