Background/Aims: To evaluate the clinical features and prognosis of patients with oral verrucous carcinoma (OVC) in an endemic betel quid chewing area. Methods: A retrospective review was conducted in 39 patients with OVC treated surgically from 1991 to 2002. Results: Thirty-seven patients (94.9%) were male. The median age at diagnosis was 53.8 years. All patients had been exposed to betel quid, cigarette smoking, and/or alcohol. The most common site of tumor origin was the buccal mucosa (64.1%). The tumor control rate was 97.4% after the first surgical procedure. Second/multiple primary tumors (SPTs/MPTs) were found in 21 patients. There were 13 deaths during the follow-up period, with SPTs/MPTs being the most common cause. The cancer-specific survival rate was 89.1% at 5 years, but continued to decrease thereafter. Conclusion: Surgery was effective for controlling OVC. However, long-term follow-up was necessary because of the high incidence of SPTs/MPTs and its impact on patient survival.

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