To evaluate the efficacy of multidisciplinary enhanced recovery after surgery (ERAS)-based nursing model in patients undergoing radical oral cancer resection and its impact on postoperative recovery.

A total of 288 patients undergoing radical oral cancer resection during December 2023-August 2025 were randomized to ERAS ( n = 144) or control group ( n = 144). Outcome measures included time to first feeding, length of hospital stay (LOS), complications, pain (Visual Analog Scale, VAS), inflammatory cytokines [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], and quality of life (QoL) [36-Item Short Form Health Survey (SF-36), Functional Assessment of Cancer Therapy-General (FACT-G), Satisfaction With Life Scale (SWLS)]. Subgroup analyses were based on age, tumor stage, and preoperative nutrition.

At day 7, RAS significantly reduced time to first feeding (17.93 ± 1.13 h vs. 26.56 ± 1.23 h) and LOS (8.35 ± 0.62 d vs. 12.18 ± 0.55 d; P < 0.001). ERAS also lowered VAS scores, IL-6, and TNF-α, while elevated SF-36, FACT-G, and SWLS scores ( P < 0.001). Complications decreased in the ERAS group for infection (0.7 % vs. 27.8 %) and dysphagia (20.1 % vs. 67.4 %; P < 0.001). The ERAS group showed superior QoL trajectories and reduced adverse outcome risks (RR < 1, 95 % CI excluding 1). Subgroups with greatest benefit included age ≥ 60 years, malnutrition, and early-stage disease (interaction P < 0.05).

Multidisciplinary ERAS-based nursing accelerates recovery, reduces complications, and improves QoL post oral cancer surgery, with enhanced efficacy in elderly, malnourished, and early-stage patients.