Verrucous carcinoma of the oral mucosa: An epidemiological and follow-up study of patients treated with surgery in 5 last years

Abstract

Introduction: Oral Verrucous Carcinoma (OVC) is described apart of the Squamous Cell Carcinoma (SCC) due to its specific properties. The objective of our study is to show our series of cases of OVC and to compare with the SCC in terms of clinical manifestations, epidemiology, histopathology, treatment and follow-up. Material and Methods: This is a retrospective study of all the OVC treated in our department between January-2007 and December-2011. The analyzed variables were sex, age, localization in the oral cavity, histopathology, number of biopsies needed to diagnose OVC, TNM classification, treatment and recurrences during follow-up. Results: Our sample was composed by n=14 patients, 57% female, with a mean age of 69.14 years. The most common localization was buccal mucosa (n=5). Seven patients were diagnosed of OVC with the first biopsy. TNM classification was: pT1: 7 patients, pT2: 3 patients, pT3: 3 patients, pT4: 1 patient. No cervical metastases were observed either in cervical neck dissection or during the follow-up of the patients. The treatment was surgery with clinical resection margins up to 1 cm in all cases, followed by radiotherapy in selected cases. Only n=1 patient (7.69%) presented a recurrence after 34 months of follow-up. The overall survival rate was 92.85%. Conclusions: In our population, OVC represents the 6.16% of all oral cavity and oropharynx cancer, and is more frequent in female patients above 70 years old. It uses to rise over a previous lesion, and usually affects the buccal mucosa. In patients with high suspicious lesions, more than one biopsy may be needed to diagnose OVC. No patient showed cervical dissemination. In our experience, treatment based on local resection, without cervical neck dissection, could be a good option for these patients. Key words:Verrucous carcinoma, squamous cell carcinoma, oral cancer, oral cavity, epidemiology, follow-up.

The Epidemiological Pattern of Premalignant and Malignant Epithelial Lesions in Northeast of Iran: A 43-Year Evaluation

“…In this study, the mean age of patients with verrucous carcinoma was reported as 64.13 years, which was similar to results in a study by Candau-Alvarez et al (24). Budimir et al (26) reported the mean age of patients with lichen planus as 67.23 years that is somewhat older than patients of OLP in present study (44.65), because most patients in Richter et al study were in 5th or 6th decade of their life.…”

“…But also in recent decades the growing tendency of women to consumption of alcohol and cigarettes throughout the world leads to a reduction of male to female ratio in oral cancer (3). (10) 1 (5) 8 (40) 3 (15) 5 ( Our results regarding the verrucous carcinoma samples showed high prevalence in men (57.9%) compared to women (42.11%) in this group of the lesions, which is inconsistent with the findings of Candau-Alvarez et al (24).…”

“…Similarly, Candau-Alvarez et al (24) reported buccal mucosa as the first site of involvement in verrucous carcinoma cases.…”

Oral verrucous carcinoma: From multifactorial etiology to diverse treatment regimens (Review)

“…Incomplete or excessive resection often accelerates tumor growth, leading to anaplastic transformation, poor function and difficult reconstruction. In this case, surgery (e.g., primary tumor resection and neck dissection) combined with radiotherapy and chemotherapy may be appropriate to minimize tumor recurrence and undesired prognosis (88)(89)(90). Table II shows the uses of surgery for OVC since mid-1980s, clearly demonstrating its effectiveness after treatment (91-94).…”

A population‐based analysis of verrucous carcinoma of the oral cavity

“…Despite the scarcity of studies, principles regarding the general management of VC have been widely adopted and practiced by oncologic surgeons. For instance, the primary tumor site does not appear to influence management because surgery remains the primary treatment modality . Earlier studies endorsed management with primary radiation therapy; however, this fell out of favor due to groups reporting anaplastic transformation of lesions following treatment .…”