{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T05:03:26Z","timestamp":1784178206640,"version":"3.55.0"},"reference-count":22,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011892","name":"Kaohsiung Chang Gung Memorial Hospital","doi-asserted-by":"publisher","award":["CMRPG8Q0081"],"award-info":[{"award-number":["CMRPG8Q0081"]}],"id":[{"id":"10.13039\/501100011892","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Oral Diseases"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the prognostic value of the margin\u2010to\u2013depth of invasion ratio (MDR) combined with nodal classification in stages I\u2013III oral squamous cell carcinoma (OSCC) without conventional adverse pathological features (CAPFs) treated with curative resection alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included 820 patients with pT1\u20133N0\u20131 OSCC without CAPFs treated with curative resection without adjuvant therapy between January 2005 and April 2017 at a tertiary referral center. The MDR cutoff was identified using Youden's index with bootstrap validation. Cancer\u2010specific survival (CSS) and relapse\u2010free survival (RFS) were analyzed using Cox models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      An MDR cutoff of 0.92 stratified outcomes. MDR \u2265\u20090.92 was associated with better 5\u2010year CSS (96.8% vs. 90.0%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and RFS (88.6% vs. 81.5%). Low MDR and pN1 were independent adverse predictors. The combined cohort identified a small but highly aggressive subgroup: patients with low MDR plus pN1 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200916) had the worst outcomes (5\u2010year CSS 56.3%, 95% CI: 36.5%\u201386.7%; 5\u2010year RFS 37.5%, 95% CI: 19.9%\u201370.6%) compared with the other subgroups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low MDR plus pN1 identified a high\u2010risk subgroup in OSCC without CAPFs; accordingly, patients with both features might require closer surveillance and further evaluation of adjuvant treatment strategies in clinical situations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/odi.70425","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T04:13:52Z","timestamp":1784175232000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low Margin\u2010To\u2010Depth of Invasion Ratio Plus\n                    <scp>pN1<\/scp>\n                    Predict Poor Prognosis in Oral Cancer Without Adverse Features"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4735-0799","authenticated-orcid":false,"given":"Ko\u2010Chun","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung 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College of Medicine National Sun Yat\u2010Sen University  Kaohsiung Taiwan"},{"name":"Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4055-1686","authenticated-orcid":false,"given":"Chao\u2010Hui","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"},{"name":"School of Medicine Chang Gung University College of Medicine  Taoyuan Taiwan"},{"name":"School of Medicine, College of Medicine National Sun Yat\u2010Sen University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University 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