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Michael W. Mulholland, MD; Fernando Megallanes, MD; Barry H. J. Press, MD; Alan R. Shons, MD, PhD; Donald G. McQuarrie, MD, PhD

Arch Surg. 1984;119(4):394-399.

Abstract
• Fifty-three consecutive unrandomized patients with squamous cell cancer of the oral tongue were retrospectively studied to compare the results of an aggressive surgical approach performed as primary therapy or as salvage after irradiation failure. Twenty-five patients underwent surgery primarily, while 23 of 28 patients treated with curative irradiation required surgical salvage. Tumor staging was equivalent between the two groups. Local recurrences at the site of origin of the tumor within two years postoperatively were significantly more frequent in salvage patients (10.0%) than in primary surgical patients (5.5%). Cervical lymph node recurrences within five years were more frequent in the salvage surgery group (74.8% V 36.7%). Systemic metastases developed in a similar proportion in both groups. Determinate fiveyear survivals were nearly identical (55.2% v 55.5%). Although recurrence rates were significantly higher after irradiation and salvage surgery, an aggressive surgical effort in patients who are irradiation failures can result in five-year survival rates matching those of surgical patients.

(Arch Surg 1984;119:394-399)

Author Affiliations
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Minnesota Hospitals, Minneapolis, and the Minneapolis Veterans Administration Hospital.

Footnotes
Accepted for publication Nov 28, 1983.

Read before the Seventh Annual Surgical Symposium of the Association of Veterans Administration Surgeons, Airlie, Va, May 26, 1983.

Reprint requests to Department of Surgery (112), VA Medical Center, 54th Street and 48th Avenue S, Minneapolis, MN 55417 (Dr McQuarrie).

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