Supplementary Material

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Background: It is unclear whether age plays a crucial role in the oral cancer prognosis. We aimed to compare the clinicopathological parameters, outcomes, and trends of patients aged < 65 years (middle age, MA) and ≥ 65 years (old age, OA) with oral squamous cell carcinoma (OSCC).

Methods: Data of 862 OSCC patients who underwent surgery at the Taipei MacKay Memorial Hospital between 1997 and 2017 were obtained. The patients were divided intoMA and OA groups. Tumor size, nodal invasion, tumor location, radiotherapy status, pathological features, and prognosis were compared. The chi-square test was used for statistical analysis. We calculated the hazard ratios and 95% confidence intervals of all-cause mortality risk between the two groups.

Results: Significant differenceswere noted in sex, tumor location, and survival rate between the groups. Sex, late-stage cancer, positive nodal invasion, and moderate differentiation significantly increased the mortality risks in the OA group compared to those in theMAgroup. In addition, OA group patients without diabetes mellitus (DM), perineural invasion, lymphovascular invasion, recurrence, secondary primary cancer, and distant metastases also showed a higher mortality risk than other patients.

Conclusion: Aging could be a predictive prognostic factor for OSCC, particularly for tumor location and survival rate. Radiotherapy after surgery could increase the survival rate of OA patients with nodal invasion.