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Participants Treatment-naive patients with oral cancer who presented to our head and neck surgical oncology OPD with an Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 2 or less and who consented to participate in the study were included

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Risk of bias assessment Only one study was classified as having low risk of bias 27 , while nearly all studies 23-26,28-33 (10 out of 11) were judged to have a high risk of bias or poor quality, primarily due to the domain of outcome measurement (Supplementary file Tables 6 and 7)

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