Adjuvant radiotherapy is not supported in patients with verrucous carcinoma of the oral cavity.
To analyze the impact of adjuvant radiation therapy (RT) on overall survival (OS) and disease-specific survival (DSS) in patients with verrucous carcinoma (VC) as compared to squamous cell carcinoma (SCC) of the oral cavity.



Cross-sectional population analysis.



Cases of nonmetastatic VC/SCC of the oral cavity were extracted from the Surveillance, Epidemiology, and End Results (SEER) database (1988-2013). Kaplan-Meier survivals, stratified according to T stage, were compared between VC and SCC for treatment with or without adjuvant RT.



A total of 18,819 VC/SCC cases were identified. There were 581 (3.1%) VC (mean age 69.6 years, 48.9% female) versus 18,238 (97.0%) SCC (mean age, 65.3, 37.1% female) patients. Verrucous carcinoma patients receiving surgery alone (N = 539) demonstrated a trend toward improved OS versus VC patients receiving surgery and RT (N = 40) (117.0 vs. 71.4 months, respectively, P = 0.119). There was a statistically significant improvement in DSS in VC patients receiving surgery alone (217.2 vs. 110.9 months, P = 0.05). Verrucous carcinoma patients treated with adjuvant RT demonstrated a trend toward a worse OS (71.4 vs. 93.0 months, P = 0.992) and DSS (110.9 vs. 162.3 months, P = 0.275) compared to SCC treated with adjuvant RT, suggesting a different biology and radiosensitivity between VC and SCC.



Verrucous carcinoma treated with adjuvant RT had a worse OS and DSS compared to both VC treated with surgery alone and SCC treated with surgery and adjuvant RT. Consideration should be given to surgical re-section rather than adjuvant RT in patients with positive margins or local recurrence.



2C. Laryngoscope, 127:1334-1338, 2017.
Department of Otology and Laryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.
Suresh
S
Mohan
Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
Sara I
SI
Pai
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, U.S.A.
Neil
N
Bhattacharyya
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D018289:Carcinoma, Verrucous / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D003430:Cross-Sectional Studies; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009055:Mouth; D009062:Mouth Neoplasms / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D018714:Radiotherapy, Adjuvant / Q000379:methods / Q000401:mortality*; D018426:SEER Program; D000077195:Squamous Cell Carcinoma of Head and Neck; D016896:Treatment Outcome
SEER; T stage; Verrucous carcinoma; cancer; head and neck cancer; oral cavity; radiation therapy; survival