Objectives: Due to the rarity of oral cavity verrucous carcinoma (OC-VC), previous studies have been limited to single-institution studies and small case series. This study analyzes the demographic, clinical, and pathologic features of patients with OC-VC and their prognostic importance using US population-based data.
Study design: Retrospective analysis of large population database
Methods: The Surveillance, Epidemiology, and End Results program database was queried for OC-VC cases between the years of 1973 and 2012. Data were analyzed with respect to various demographic and clinicopathologic factors. The Kaplan-Meier model was used to analyze disease-specific survival (DSS).
Results: Among the 1408 patients with OC-VC identified, mean age at diagnosis was 69.9 (± 13.9) years and 51% of patients were male. The most frequent sites of primary tumor were the tongue (30.4%), gum (22.7%), and buccal mucosa (20.0%). Five-year disease-specific survival (DSS) was 77.1%. Survival varied by anatomic site with tumors in the floor of mouth, hard palate, and retromolar area (5-yr DSS 67.7%, 68.0%, and 68.4%, respectively) conveying a relatively poorer prognosis (p = 0.004). Other negative prognostic indicators include advanced stage disease (p < 0.001), age greater than 50 years (p < 0.001), and tumor size greater than 3cm (p = 0.02). Five-year DSS was better among those treated with surgery alone (81.5%) relative to surgery and radiotherapy (55.6%) or radiotherapy alone (47.5%) (p < 0.001). No differences in survival were observed with regard to race/ethnicity, sex, diagnosis year, or histologic grade.
Conclusion: This study represents the largest series of OC-VCs to date. Prognosis is associated with age at diagnosis, anatomic subsite, stage, tumor size, and treatment type. Surgery alone is primary treatment modality for OC-VC, with a favorable prognosis. Adjuvant radiotherapy does not appear to confer a survival benefit.