title: Evaluation of the effectiveness of postoperative radiation therapy for the control of local disease.
abstract: Although we agree that postoperative irradiation does improve the local and regional control, our findings indicate that the rate of control, especially local control, is somewhat less than 90 percent. Our data reveal a recurrence rate of 32.7 percent in advanced, stage III and IV, squamous cell carcinomas in the head and neck treated by surgery and postoperative irradiation; this rate may be even greater with longer follow-up. We recommend that surgeons avoid "close" surgical margins (less than 5 mm) when resecting primary cancers and not rely too heavily on radiation therapy to control residual subclinical disease. It appears that continued study is needed to establish the true efficacy of irradiation in the control of subclinical disease, and that local recurrence must be differentiated from regional recurrence when reporting these results.
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D009364:Neoplasm Recurrence, Local; D011182:Postoperative Care