In our study, although the tumor stage of each OTSCC patient who underwent surgical resection was determined according to the 7th AJCC staging system, the results showed negative nodal metastasis and low expression of Nox4 were significantly associated with superior DFS and OS and the N0 status was not changed whether in the 7th or 8th AJCC staging system. The gene discussed is NOX4; the disease is neoplasm.