Results of surgery alone and surgery combined with postoperative radiotherapy in the treatment of cancer of the parotid gland.

Seventy-seven patients with primary malignant parotid tumors were studied and the various factors relative to their disease, as well as their treatment, were analyzed. Because of the retrospective nature of this study, no attempt was made to compare surgery alone with surgery and postoperative radiation, but it was interesting to reflect on the relative and absolute indications for the use of combined treatment versus surgery alone. The above-clavicle control in this group of patients was excellent, and the relatively low incidence of distant metastases reflect that optimal local control was closely correlated with survival. Sacrifice of the facial nerve should not be routinely based on the histologic characteristics of the tumor but rather on the findings at the time of surgery. Elective regional node dissection was indicated as a staging adjuvant and to provide extra exposure and soft tissue margins of excision in large tumors without producing any significant additional morbidity.