Abstract
Both surgery and irradiation have a role in the treatment of mouth cancer. Alone or in combination, they are the only effective means currently available. Depending on the facilities at hand and the experience and skill of the clinician, small lesions (3 cm or less) may be successfully treated by either local surgery or local irradiation. High cure rates may be expected in almost equal numbers by either method. 6 Their relative merits are not the subject of this discussion. In a significant portion of patients with oral cancer—the majority in our experience — the initial clinical presentation is unfavorable. Extensive infiltration at the primary site plus invasion of adjacent structures lessens the chance of local control of the disease by either irradiation alone or surgery alone. Likewise, clinical evidence of regional lymph node spread indicates a poor prognosis. Just how poor it is is seldom appreciated. 7 The shortcomings
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