ArticleCancers2026
Refusal of Guideline-Recommended Adjuvant Therapy in Oral Squamous Cell Carcinoma Is Associated with Less Favorable Survival Outcomes.
Article in Cancers, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
BACKGROUND/
objectivesGuideline-recommended adjuvant therapy, including radiotherapy alone or concurrent chemoradiotherapy, is an established component of treatment for patients with high-risk oral squamous cell carcinoma (OSCC). However, a considerable proportion of patients (30.7%) refuse postoperative treatment despite a clear guideline-based recommendation. Data on determinants of treatment refusal and its association with oncologic outcomes remain limited.
methodsThis retrospective single-center cohort study included 88 patients with histologically confirmed OSCC and a clear indication for adjuvant therapy between 2015 and 2021. Overall survival (OS) and disease-free survival (DFS) were estimated using the Kaplan-Meier method. Group comparisons were performed using Breslow tests to account for potential early differences in survival. Exploratory Cox proportional hazards models were calculated for OS to assess the association between completion of adjuvant therapy and survival after limited adjustment for clinically relevant covariates.
resultsRefusal of indicated adjuvant therapy occurred in 27 of 88 patients (30.7%) and was significantly associated with older age (
conclusionsRefusal of guideline-recommended adjuvant therapy is frequent in patients with high-risk OSCC and was associated with less favorable survival patterns in this cohort. Given the retrospective design, limited sample size, and exploratory nature of the analyses, these findings should be interpreted as associative rather than causal. Nevertheless, they highlight the potential clinical relevance of treatment adherence and support the importance of patient-centered counseling to improve uptake of guideline-recommended postoperative therapy.
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