Kang, Chung-JanChung-JanKangWen, Yu-WenYu-WenWenLin, Chien-YuChien-YuLinNg, Shu-HangShu-HangNgTsai, Yao-TeYao-TeTsaiKu, Hsiu-YingHsiu-YingKuPEI-JEN LOUCHENG-PING WANGLin, Jin-ChingJin-ChingLinHua, Chun-HungChun-HungHuaLee, Shu-RuShu-RuLeeFan, Kang-HsingKang-HsingFanChen, Wen-ChengWen-ChengChenLee, Li-YuLi-YuLeeChien, Chih-YenChih-YenChienChen, Tsung-MingTsung-MingChenTerng, Shyuang-DerShyuang-DerTerngTsai, Chi-YingChi-YingTsaiWang, Hung-MingHung-MingWangHsieh, Chia-HsunChia-HsunHsiehYeh, Chih-HuaChih-HuaYehLin, Chih-HungChih-HungLinTsao, Chung-KanChung-KanTsaoCheng, Nai-MingNai-MingChengFang, Tuan-JenTuan-JenFangHuang, Shiang-FuShiang-FuHuangLee, Li-AngLi-AngLeeFang, Ku-HaoKu-HaoFangWang, Yu-ChienYu-ChienWangLin, Wan-NiWan-NiLinHsin, Li-JenLi-JenHsinYen, Tzu-ChenTzu-ChenYenLiao, Chun-TaChun-TaLiao2025-05-082025-05-082025-02https://scholars.lib.ntu.edu.tw/handle/123456789/729051Background: The question as to whether prolonged diagnosis-to-surgery intervals (DSIs) may compromise survival outcomes in patients with oral cavity squamous cell carcinoma (OCSCC) remains unanswered. This nationwide study was designed to address this issue. Methods: We analyzed data from 26,214 patients with first primary OCSCC identified in the Taiwanese Cancer Registry Database between 2011 and 2021. The optimal DSI cutoff was determined based on 5-year disease-specific survival (DSS) and overall survival (OS) rates using Cox regression analysis. Patients were categorized into three distinct DSI groups: ≤20 days (47 %), 21–31 days (31 %), and > 31 days (22 %). Results: The 5-year DSS and OS rates for the ≤20/21–31/>31 days groups were 81 %/78 %/77 % and 73 %/70 %/68 %, respectively (both p < 0.0001). Patients in the ≤20 days group had a higher prevalence of pathological stages I–II. After adjustment for potential confounders in multivariable analysis, a DSI > 31 days (versus ≤ 20 days) retained independent associations with adverse outcomes at 5 years, with hazard ratios of 1.07 for both DSS and OS. Propensity score matching and multivariable analysis comparing DSI ≤ 20 days to DSI > 31 days stratified by pathological stage III–IV showed that higher DSS and OS rates were observed in patients with DSI ≤ 20 days than DSI > 31 days (68 %/66 %, p = 0.0586; 60 %/57 %, p = 0.0228, respectively), with hazard ratios of 1.09 for both DSS and OS. Conclusions: Our findings indicate that DSI is an independent predictor of 5-year DSS and OS in patients with OCSCC. A DSI exceeding 31 days, or even 21 days, may potentially decrease survival outcomes.enCancer registryDiagnosis-to-surgery intervalDisease-specific survivalNationwide studyOral cavity squamous cell carcinomaOverall survivalTreatment delay[SDGs]SDG3journal article10.1016/j.oraloncology.2025.10719639842233