{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T22:21:15Z","timestamp":1793917275501,"version":"4.8.0"},"reference-count":31,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"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: To evaluate the association between comorbidity burden, quantified using the Charlson Comorbidity Index (CCI), and overall survival (OS) and disease-free survival (DFS) in patients treated surgically for oral cavity squamous cell carcinoma (OCSCC), and to determine whether this association is modified by tumor stage. Methods: We retrospectively analyzed 325 patients treated with primary surgery for OCSCC at a single institution (2009\u20132021). CCI was scored excluding the index malignancy component and evaluated as a continuous variable. Univariate and multivariable Cox proportional hazards models assessed the association between CCI and OS\/DFS, including a formal CCI \u00d7 stage interaction term. Kaplan\u2013Meier curves stratified by CCI (&gt;4 vs. \u22644) were generated separately in early- and advanced-stage subgroups and compared by log-rank test. Results: CCI was significantly associated with OS (HR 1.14 per point, 95% CI 1.04\u20131.25, p = 0.005) but not DFS (HR 1.02, 95% CI 0.92\u20131.12, p = 0.768). A significant CCI \u00d7 stage interaction was observed (HR 0.82, 95% CI 0.68\u20130.99, p = 0.036): within early-stage patients, an elevated CCI (&gt;4) was associated with a significantly worse 5-year OS (52.9% vs. 72.3%, p = 0.009), whereas no such difference was observed in advanced-stage patients (40.9% vs. 42.6%, p = 0.56). Conclusions: The comorbidity burden was associated with overall but not disease-free survival after surgery for OCSCC. The association differed by tumor stage and was most apparent in early-stage disease. A recurrence-based classification of deaths showed that non-cancer death accounted for a substantially larger share of mortality among early-stage than advanced-stage patients, supporting a competing-mortality mechanism; independently adjudicated cause-of-death data were not available to confirm this directly. CCI may provide additional prognostic information in early-stage OCSCC.<\/jats:p>","DOI":"10.3390\/cancers18172825","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:33:32Z","timestamp":1788262412000},"page":"2825","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comorbidity Burden and Survival After Primary Surgery for Oral Cavity Squamous Cell Carcinoma: Tumor Stage as an Effect Modifier"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6834-5369","authenticated-orcid":false,"given":"Mateusz","family":"Szewczyk","sequence":"first","affiliation":[{"name":"Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-701 Pozna\u0144, Poland"},{"name":"Department of Head and Neck Surgery, Greater Poland Cancer Center, 61-866 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"given":"Krzysztof","family":"Przybylski","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-701 Pozna\u0144, Poland"},{"name":"Department of Head and Neck Surgery, Greater Poland Cancer Center, 61-866 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"}]},{"given":"Bartosz","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Greater Poland Cancer Center, 61-866 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4677-0783","authenticated-orcid":false,"given":"Bartosz","family":"Wojtera","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-701 Pozna\u0144, Poland"},{"name":"Department of Head and Neck Surgery, Greater Poland Cancer Center, 61-866 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Dominika","family":"Wojnar","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Greater Poland Cancer Center, 61-866 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"}]},{"given":"Damian","family":"Rusek","sequence":"additional","affiliation":[{"name":"Department of Cancer Pathology and Prevention, Greater Poland Cancer Center, 61-866 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"investigation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Jakub","family":"Pazdrowski","sequence":"additional","affiliation":[{"name":"Department of Head and Neck Surgery, Poznan University of Medical Sciences, 61-701 Pozna\u0144, Poland"},{"name":"Department of Head and Neck Surgery, Greater Poland Cancer Center, 61-866 Pozna\u0144, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,1]]},"reference":[{"key":"ref_1","first-page":"1","article-title":"Global incidence of lip, oral cavity, and pharyngeal cancers by subsite in 2022","volume":"76","author":"Rumgay","year":"2026","journal-title":"CA Cancer J. 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