Oral verrucous lesions are relatively rare, and management guidelines for these tumours are extrapolated from squamous cell carcinoma. There is a paucity of knowledge about the need for elective neck treatment, adjuvant therapy, and the role of pathological prognosticators.

A retrospective study was conducted on consecutive cases showing verrucous hyperplasia (VH)/verrucous carcinoma (VC) of the oral cavity.

A total of 107 patients were identified. The median follow-up was 42 months. Preoperative biopsy showed poor diagnostic accuracy in accurately classifying oral verrucous lesions (sensitivity 22%). The 5-year overall survival (OS) and disease-free survival (DFS) for VH and VC were 76.3%, 72.76%, 56.8%, and 53.8%, respectively. Local recurrence was the most common pattern of failure. No impact of margin status and neck dissection was noted on OS, DFS, and local and regional controls in the univariate model. Adjuvant radiotherapy was associated with improved local control in the univariate model, but the benefit was lost when confounders were adjusted for in the multivariate model. Of all the variables considered in the multivariable model, the AJCC stage was the only independent prognostic factor for OS.

Neck dissection and adjuvant radiotherapy which are important determinants of outcome in squamous cell carcinoma did not show oncological benefit in this cohort of oral verrucous lesions.