{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T10:42:56Z","timestamp":1792233776876,"version":"4.4.0"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Importance:<\/jats:title>\n                    <jats:p>Older adults with oral cavity squamous cell carcinoma (OCSCC) are underrepresented in clinical trials, and the comparative effectiveness of surgery versus definitive radiotherapy with or without chemotherapy (RT\u2009\u00b1\u2009CT) remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To compare all-cause and OCSCC-specific mortality after curative-intent surgery versus definitive RT\u2009\u00b1\u2009CT in older adults with newly diagnosed OCSCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Nationwide, population-based retrospective cohort study using linked registry and claims data. Propensity score fine stratification weighting (PS-FSW) and multivariable Cox proportional hazards models were used to reduce treatment selection bias.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting:<\/jats:title>\n                    <jats:p>Taiwan Cancer Registry, National Health Insurance Research Database, and Taiwan Death Registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants:<\/jats:title>\n                    <jats:p>Patients aged \u226565\u2009years with newly diagnosed, nonmetastatic, pathologically confirmed OCSCC between January 1, 2009, and December 31, 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention or Exposures:<\/jats:title>\n                    <jats:p>Curative-intent surgery, with or without adjuvant therapy, compared with definitive RT\u2009\u00b1\u2009CT delivered with curative-intent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures:<\/jats:title>\n                    <jats:p>All-cause mortality and OCSCC-specific mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 1275 eligible patients, 492 underwent curative-intent surgery and 783 received definitive RT\u2009\u00b1\u2009CT. After PS-FSW, baseline characteristics were well balanced. Surgery was associated with lower all-cause mortality (adjusted hazard ratio [aHR] 0.59; 95% confidence interval [CI] 0.51, 0.69;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001) and lower OCSCC-specific mortality (aHR 0.63; 95% CI 0.51, 0.78;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.0001) compared with definitive RT\u2009\u00b1\u2009CT. The survival benefit persisted across age strata, including patients aged \u226585\u2009years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Curative-intent surgery was associated with superior all-cause and cancer-specific survival compared with definitive RT\u2009\u00b1\u2009CT among older adults with OCSCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance:<\/jats:title>\n                    <jats:p>Chronological age alone should not preclude surgical consideration in older adults with OCSCC. Treatment decisions should incorporate physiologic fitness, comorbidity burden, geriatric assessment, and multidisciplinary evaluation; future studies should further evaluate treatment-related toxicity, functional outcomes, and quality-of-life.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216261468732","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T12:16:39Z","timestamp":1785327399000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgery Versus Radiotherapy in Older Adults with Oral Cavity Cancer: A Nationwide Comparative Effectiveness Study"],"prefix":"10.1177","volume":"55","author":[{"given":"Kuan-Chou","family":"Lin","sequence":"first","affiliation":[{"name":"Division of Oral and Maxillofacial Surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taiwan"},{"name":"School of Dentistry, College of Oral Medicine, Taipei Medical University, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia-Lun","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Hemato-Oncology, Wan Fang Hospital, Taipei Medical University, Taiwan"},{"name":"Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan-Ming","family":"Chen","sequence":"additional","affiliation":[{"name":"Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taiwan"},{"name":"Artificial Intelligence Development Center, Fu Jen Catholic University, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben-Chang","family":"Shia","sequence":"additional","affiliation":[{"name":"Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taiwan"},{"name":"Artificial Intelligence Development Center, Fu Jen Catholic University, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5637-558X","authenticated-orcid":false,"given":"Szu-Yuan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan"},{"name":"Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan"},{"name":"Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan"},{"name":"Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan"},{"name":"Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan"},{"name":"Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih-Yuan","family":"Fang","sequence":"additional","affiliation":[{"name":"Division of Oral and Maxillofacial Surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taiwan"},{"name":"School of Dentistry, College of Oral Medicine, Taipei Medical University, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"crossref","unstructured":"Tan Y Wang Z Xu M et al. 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