{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:39:12Z","timestamp":1790959152367,"version":"4.1.0"},"reference-count":60,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T00:00:00Z","timestamp":1750377600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Acetylsalicylic acid (ASA) medication has been suggested to have a beneficial effect on cancer risk and survival. Therefore, this retrospective case\u2013control study investigated the correlation between ASA and HNC in over 11,000,000 patients to investigate the impact of ASA intake on the risk of developing HNC, five-year survival rates, and the likelihood of secondary malignant neoplasms and malignant lymph node involvement. Methods: Retrospective clinical data was retrieved from a federated EHR network. Patients prescribed ASA were assigned to Cohort I, while those who were not prescribed ASA were assigned to Cohort II. Moreover, patients diagnosed with HNC, and prescribed ASA were assigned to Cohort III, while those with HNC but no history of ASA use were assigned to Cohort IV. Results: After matching, Cohorts I and II included 5,716,056 patients each. HNC incidence was significantly lower (OR 0.88; 95% CI 0.86\u20130.90) in Cohort I (+ASA) compared to Cohort II (\u2212ASA). Furthermore, five-year survival was higher for patients taking ASA medication (survival probability 67.93%) compared to patients who did not (65.54%). These findings coincide with a lower risk of death of 22.8% (+ASA) compared to 23.6% (\u2212ASA), which was statistically significant (p = 0.006). Patients with ASA intake also showed a lower risk of malignant neoplasms of lymph nodes (17.4% vs. 18.5%). Conclusions: Our analyses revealed a lower risk of HNC, a higher five-year survival rate, and a lower risk of malignant neoplasms of lymph nodes in patients with ASA medication. However, the retrospective design and the lack of evaluation of confounders limit the significance of our data, and, therefore, further analyses should be considered.<\/jats:p>","DOI":"10.3390\/cancers17132065","type":"journal-article","created":{"date-parts":[[2025,6,20]],"date-time":"2025-06-20T09:04:49Z","timestamp":1750410289000},"page":"2065","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Acetylsalicylic Acid and Head and Neck Cancer: Risk, Five-Year Survival, and Recurrence in over 11,000,000 Patients\u2014A Retrospective Case\u2013Control Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1807-2531","authenticated-orcid":false,"given":"Jonas","family":"W\u00fcster","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Medical Center, University of Freiburg, 79085 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Heene","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Medical Center, University of Freiburg, 79085 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4697-5287","authenticated-orcid":false,"given":"Leonard","family":"Brandenburg","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Medical Center, University of Freiburg, 79085 Freiburg im Breisgau, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2407-1087","authenticated-orcid":false,"given":"Robert","family":"Preissner","sequence":"additional","affiliation":[{"name":"Institute of Physiology and Science-IT, Charit\u00e9-Universit\u00e4tsmedizin Berlin, 10117 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Nahles","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4987-2913","authenticated-orcid":false,"given":"Max","family":"Heiland","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3672-0283","authenticated-orcid":false,"given":"Saskia","family":"Preissner","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, Charit\u00e9-Universit\u00e4tsmedizin Berlin, 13353 Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1038\/s41415-022-5166-x","article-title":"Reviewing the Epidemiology of Head and Neck Cancer: Definitions, Trends and Risk Factors","volume":"233","author":"Gormley","year":"2022","journal-title":"Br. Dent. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1038\/s41572-020-00224-3","article-title":"Head and neck squamous cell carcinoma","volume":"6","author":"Johnson","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1002\/hed.26460","article-title":"Untreated Head and Neck Cancer: Natural History and Associated Factors","volume":"43","author":"Zolkind","year":"2021","journal-title":"Head Neck"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1056\/NEJMra1715715","article-title":"Head and Neck Cancer","volume":"382","author":"Chow","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Tumban, E. (2019). A Current Update on Human Papillomavirus-Associated Head and Neck Cancers. Viruses, 11.","DOI":"10.3390\/v11100922"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"966","DOI":"10.5306\/wjco.v5.i5.966","article-title":"Chemotherapy Advances in Locally Advanced Head and Neck Cancer","volume":"5","author":"Georges","year":"2014","journal-title":"World J. Clin. Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"W\u00fcster, J., Heiland, M., Nahles, S., Preissner, R., and Preissner, S. (2023). Statin Medication Improves Five-Year Survival Rates in Patients with Head and Neck Cancer: A Retrospective Case-Control Study of about 100,000 Patients. Cancers, 15.","DOI":"10.3390\/cancers15123093"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1001\/jamaoto.2023.4739","article-title":"Exogenous Estrogen in the Development of Head and Neck Cancer","volume":"150","author":"Doll","year":"2024","journal-title":"JAMA Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Gaertner, F., Preissner, S., Heiland, M., Preissner, R., and W\u00fcster, J. (2024). Beneficial Effect of Metformin on the Five-Year Survival in about 40,000 Patients with Head and Neck Cancer. Cancers, 16.","DOI":"10.3390\/cancers16050982"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Marko, V. (2020). From Aspirin to Viagra: Stories of the Drugs That Changed the World, Springer.","DOI":"10.1007\/978-3-030-44286-6"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Fija\u0142kowski, \u0141., Skubiszewska, M., Grze\u015bk, G., Koech, F.K., and Nowaczyk, A. (2022). Acetylsalicylic Acid-Primus Inter Pares in Pharmacology. Molecules, 27.","DOI":"10.3390\/molecules27238412"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1111\/bjh.14520","article-title":"The Aspirin Story\u2014From Willow to Wonder Drug","volume":"177","author":"Desborough","year":"2017","journal-title":"Br. J. Haematol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"36","DOI":"10.14797\/mdcvj.293","article-title":"Aspirin in the Modern Era of Cardiovascular Disease Prevention","volume":"17","author":"Murphy","year":"2021","journal-title":"Methodist DeBakey Cardiovasc. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1002\/ijc.32083","article-title":"Long-Term Use of Low-Dose Aspirin for Cancer Prevention: A 10-Year Population Cohort Study in Hong Kong","volume":"145","author":"Tsoi","year":"2019","journal-title":"Int. J. Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1016\/S0140-6736(20)30366-4","article-title":"Cancer Prevention with Aspirin in Hereditary Colorectal Cancer (Lynch Syndrome), 10-Year Follow-up and Registry-Based 20-Year Data in the CAPP2 Study: A Double-Blind, Randomised, Placebo-Controlled Trial","volume":"395","author":"Burn","year":"2020","journal-title":"Lancet Lond. Engl."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1158\/1940-6207.CAPR-20-0123","article-title":"Association of Aspirin, Metformin, and Statin Use with Gastric Cancer Incidence and Mortality: A Nationwide Cohort Study","volume":"14","author":"Cho","year":"2021","journal-title":"Cancer Prev. Res. Phila. Pa"},{"key":"ref_18","first-page":"801","article-title":"Regular Aspirin Use and Stomach Cancer Risk in China","volume":"41","author":"Wang","year":"2015","journal-title":"Eur. J. Surg. Oncol. J. Eur. Soc. Surg. Oncol. Br. Assoc. Surg. Oncol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2394","DOI":"10.1002\/ijc.33022","article-title":"Low-Dose Aspirin and Risk of Gastric and Oesophageal Cancer: A Population-Based Study in the United Kingdom Using The Health Improvement Network","volume":"147","author":"Vora","year":"2020","journal-title":"Int. J. Cancer"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1158\/1055-9965.EPI-16-0508","article-title":"Aspirin Use and Reduced Risk of Pancreatic Cancer","volume":"26","author":"Risch","year":"2017","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1018","DOI":"10.1056\/NEJMoa1912035","article-title":"Association of Aspirin with Hepatocellular Carcinoma and Liver-Related Mortality","volume":"382","author":"Simon","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.jtho.2020.08.021","article-title":"The Associations of Aspirin, Statins, and Metformin With Lung Cancer Risk and Related Mortality: A Time-Dependent Analysis of Population-Based Nationally Representative Data","volume":"16","author":"Kang","year":"2021","journal-title":"J. Thorac. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1016\/j.clbc.2021.02.005","article-title":"Aspirin Use and Risk of Breast Cancer: A Meta-Analysis of Observational Studies from 1989 to 2019","volume":"21","author":"Ma","year":"2021","journal-title":"Clin. Breast Cancer"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.bcp.2013.12.005","article-title":"Aspirin Attenuates Vinorelbine-Induced Endothelial Inflammation via Modulating SIRT1\/AMPK Axis","volume":"88","author":"Tsai","year":"2014","journal-title":"Biochem. Pharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s13277-015-3959-0","article-title":"Aspirin and Salicylic Acid Decrease C-Myc Expression in Cancer Cells: A Potential Role in Chemoprevention","volume":"37","author":"Ai","year":"2016","journal-title":"Tumour Biol. J. Int. Soc. Oncodevelopmental Biol. Med."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1064","DOI":"10.1016\/S0891-5849(00)00403-2","article-title":"Determination of Salicylate Hydroxylation Products as an in Vivo Oxidative Stress Marker","volume":"29","author":"Coudray","year":"2000","journal-title":"Free Radic. Biol. Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Ausina, P., Branco, J.R., Demaria, T.M., Esteves, A.M., Leandro, J.G.B., Ochioni, A.C., Mendon\u00e7a, A.P.M., Palhano, F.L., Oliveira, M.F., and Abou-Kheir, W. (2020). Acetylsalicylic Acid and Salicylic Acid Present Anticancer Properties against Melanoma by Promoting Nitric Oxide-Dependent Endoplasmic Reticulum Stress and Apoptosis. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-76824-6"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Heym, M., Heiland, M., Preissner, R., Huebel, C., Nahles, S., Schmidt-Westhausen, A.M., Preissner, S., and Hertel, M. (2022). The Risk of Oral Squamous Cell Carcinoma in Patients with and without Somatoform Disorders Including Bruxism: A Retrospective Evaluation of 309,278 Individuals. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.1080492"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e463","DOI":"10.1161\/CIRCULATIONAHA.106.174526","article-title":"ACC\/AHA 2005 Practice Guidelines for the Management of Patients with Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): A Collaborative Report from the American Association for Vascular Surgery\/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC\/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation","volume":"113","author":"Hirsch","year":"2006","journal-title":"Circulation"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1177\/1358863X10390838","article-title":"ACCF\/AHA\/ACR\/SCAI\/SIR\/SVM\/SVN\/SVS 2010 Performance Measures for Adults with Peripheral Artery Disease. A Report of the American College of Cardiology Foundation\/American Heart Association Task Force on Performance Measures, the American College of Radiology, the Society for Cardiac Angiography and Interventions, the Society for Interventional Radiology, the Society for Vascular Medicine, the Society for Vascular Nursing, and the Society for Vascular Surgery (Writing Committee to Develop Clinical Performance Measures for Peripheral Artery Disease)","volume":"15","author":"Olin","year":"2010","journal-title":"Vasc. Med. Lond. Engl."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2432","DOI":"10.1016\/j.jacc.2011.10.824","article-title":"AHA\/ACCF Secondary Prevention and Risk Reduction Therapy for Patients with Coronary and Other Atherosclerotic Vascular Disease: 2011 Update: A Guideline from the American Heart Association and American College of Cardiology Foundation Endorsed by the World Heart Federation and the Preventive Cardiovascular Nurses Association","volume":"58","author":"Smith","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"185","DOI":"10.2147\/VHRM.S76651","article-title":"Adherence to Guideline-Recommended Therapies among Patients with Diverse Manifestations of Vascular Disease","volume":"11","author":"Chen","year":"2015","journal-title":"Vasc. Health Risk Manag."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1001\/archotol.132.11.1231","article-title":"Chemoprevention of Head and Neck Cancer with Aspirin: A Case-Control Study","volume":"132","author":"Jayaprakash","year":"2006","journal-title":"Arch. Otolaryngol. Head Neck Surg."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s10552-011-9751-6","article-title":"Non-Steroidal Anti-Inflammatory Drug and Aspirin Use and the Risk of Head and Neck Cancer: A Systematic Review","volume":"22","author":"Wilson","year":"2011","journal-title":"Cancer Causes Control"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1002\/hed.27638","article-title":"Aspirin Intake and Head and Neck Cancer: A Pooled Analysis within the INHANCE Consortium","volume":"46","author":"Sassano","year":"2024","journal-title":"Head Neck"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1007\/s10552-023-01815-7","article-title":"Aspirin Use and Head and Neck Cancer Survival and Recurrence","volume":"35","author":"Zhang","year":"2024","journal-title":"Cancer Causes Control"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1002\/ijc.33814","article-title":"Low-Dose Aspirin Use and Mortality Risk in Patients with Head and Neck Cancer: A Nationwide Cohort Study of 10 770 Patients","volume":"150","author":"Dehlendorff","year":"2022","journal-title":"Int. J. Cancer"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Luo, S.-D., Wu, S.-C., Chen, W.-C., Wu, C.-N., Chiu, T.-J., Yang, Y.-H., Li, S.-H., Fang, F.-M., Huang, T.-L., and Hsiao, C.-C. (2021). Low-Dose Aspirin Confers a Survival Benefit in Patients with Pathological Advanced-Stage Oral Squamous Cell Carcinoma. Sci. Rep., 11.","DOI":"10.1038\/s41598-021-96614-y"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1664","DOI":"10.1002\/hed.26663","article-title":"Head and Neck Cancer and Non-Steroidal Anti-Inflammatory Drugs: Systematic Review and Meta-Analysis","volume":"43","year":"2021","journal-title":"Head Neck"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Zhang, X., Feng, H., Li, Z., Guo, J., and Li, M. (2018). Aspirin Is Involved in the Cell Cycle Arrest, Apoptosis, Cell Migration, and Invasion of Oral Squamous Cell Carcinoma. Int. J. Mol. Sci., 19.","DOI":"10.3390\/ijms19072029"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.tiv.2010.01.010","article-title":"Aspirin Induces Apoptosis in YD-8 Human Oral Squamous Carcinoma Cells through Activation of Caspases, down-Regulation of Mcl-1, and Inactivation of ERK-1\/2 and AKT","volume":"24","author":"Park","year":"2010","journal-title":"Toxicol. Vitro Int. J. Publ. Assoc. BIBRA"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/S1098-8823(03)00053-4","article-title":"Regulation of Cell Growth by Selective COX-2 Inhibitors in Oral Carcinoma Cell Lines","volume":"72","author":"Yang","year":"2003","journal-title":"Prostaglandins Other Lipid Mediat."},{"key":"ref_43","first-page":"6706","article-title":"Direct Evidence for a Role of Cyclooxygenase 2-Derived Prostaglandin E2 in Human Head and Neck Xenograft Tumors","volume":"62","author":"Zweifel","year":"2002","journal-title":"Cancer Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1623","DOI":"10.1517\/13543784.8.10.1623","article-title":"Potential Utility of COX-2 Inhibitors in Chemoprevention and Chemotherapy","volume":"8","author":"Koki","year":"1999","journal-title":"Expert Opin. Investig. Drugs"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"16737","DOI":"10.1016\/S0021-9258(17)44821-6","article-title":"The Induction and Suppression of Prostaglandin H2 Synthase (Cyclooxygenase) in Human Monocytes","volume":"265","author":"Fu","year":"1990","journal-title":"J. Biol. Chem."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1080\/10408360091174286","article-title":"Biochemistry of Cyclooxygenase (COX)-2 Inhibitors and Molecular Pathology of COX-2 in Neoplasia","volume":"37","author":"Fosslien","year":"2000","journal-title":"Crit. Rev. Clin. Lab. Sci."},{"key":"ref_47","first-page":"1306","article-title":"Antiangiogenic and Antitumor Activities of Cyclooxygenase-2 Inhibitors","volume":"60","author":"Masferrer","year":"2000","journal-title":"Cancer Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"214","DOI":"10.3181\/00379727-172-41548","article-title":"PGE2 and Angiogenesis","volume":"172","author":"Form","year":"1983","journal-title":"Proc. Soc. Exp. Biol. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"99066","DOI":"10.18632\/oncotarget.21524","article-title":"Nonsteroidal Anti-Inflammatory Drugs Using and Risk of Head and Neck Cancer: A Dose-Response Meta Analysis of Prospective Cohort Studies","volume":"8","author":"Shi","year":"2017","journal-title":"Oncotarget"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1016\/j.jcms.2015.02.011","article-title":"Postoperative Adjuvant Radiotherapy Improves Loco-Regional Recurrence of Head and Neck Mucosal Melanoma","volume":"43","author":"Wushou","year":"2015","journal-title":"J. Cranio-Maxillo-Fac. Surg."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1017\/S0022215118000555","article-title":"Management of Advanced Hypopharyngeal Carcinoma: Systematic Review of Survival Following Surgical and Non-Surgical Treatments","volume":"132","author":"Habib","year":"2018","journal-title":"J. Laryngol. Otol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1001\/jamaoto.2018.4515","article-title":"Outcomes of Cutaneous Squamous Cell Carcinoma in the Head and Neck Region With Regional Lymph Node Metastasis: A Systematic Review and Meta-Analysis","volume":"145","author":"Sahovaler","year":"2019","journal-title":"JAMA Otolaryngol.\u2014Head Neck Surg."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1093\/jjco\/hyw027","article-title":"Cigarette Smoking and the Risk of Head and Neck Cancer in the Japanese Population: A Systematic Review and Meta-Analysis","volume":"46","author":"Koyanagi","year":"2016","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"102624","DOI":"10.1016\/j.amjoto.2020.102624","article-title":"The Effect of Race in Head and Neck Cancer: A Meta-Analysis Controlling for Socioeconomic Status","volume":"41","author":"Russo","year":"2020","journal-title":"Am. J. Otolaryngol."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Takenaka, Y., Takemoto, N., Oya, R., and Inohara, H. (2021). Prognostic Impact of Sarcopenia in Patients with Head and Neck Cancer Treated with Surgery or Radiation: A Meta-Analysis. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0259288"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"3608","DOI":"10.1002\/hed.26868","article-title":"The Prognostic Impact of Depression or Depressive Symptoms on Patients with Head and Neck Cancer: A Systematic Review and Meta-Analysis","volume":"43","author":"Bardash","year":"2021","journal-title":"Head Neck"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1016\/j.oraloncology.2012.06.019","article-title":"Human Papillomavirus Related Head and Neck Cancer Survival: A Systematic Review and Meta-Analysis","volume":"48","author":"Ellison","year":"2012","journal-title":"Oral Oncol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"904","DOI":"10.1016\/j.oraloncology.2004.04.005","article-title":"Wine, Beer and Spirits and Risk of Oral and Pharyngeal Cancer: A Case-Control Study from Italy and Switzerland","volume":"40","author":"Altieri","year":"2004","journal-title":"Oral Oncol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.oraloncology.2010.03.024","article-title":"A Meta-Analysis of Alcohol Drinking and Oral and Pharyngeal Cancers. Part 1: Overall Results and Dose-Risk Relation","volume":"46","author":"Tramacere","year":"2010","journal-title":"Oral Oncol."},{"key":"ref_60","first-page":"458","article-title":"Prognostic Factors in Head and Neck Cancer: A 10-Year Retrospective Analysis in a Single-Institution in Italy","volume":"37","author":"Cadoni","year":"2017","journal-title":"Acta Otorhinolaryngol. Ital. Organo Uff. Della Soc. Ital. Otorinolaringol. E Chir. Cerv.-Facc."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/13\/2065\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:55:49Z","timestamp":1760032549000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/13\/2065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,20]]},"references-count":60,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2025,7]]}},"alternative-id":["cancers17132065"],"URL":"https:\/\/doi.org\/10.3390\/cancers17132065","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,20]]}}}