Surgical treatment of advanced carcinomas of the base of the tongue.

During the decade of 1964 through 1973, thirty-four patients with advanced squamous carcinoma of the base of the tongue (20 with T3 lesions and 14 with T4 lesions) were treated by surgical resection. These patients underwent an operative procedure as the only and definitive form of treatment. Twenty-eight (82.3 per cent) presented with clinically positive cervical nodal metastases (4 staged N1, 13 staged N2, and 11 staged N3). The number of primary lesions controlled, cervical metastasis, and the failures of treatment were analyzed. The patients were followed for a minimum of two years or until death or recurrence. The determinate control at two years was 27 per cent and the final determinate survival 20 per cent. Fifteen patients (44.2 per cent) required laryngectomy as part of the primary surgical treatment. The surgical procedures used and other therapeutic options available are discussed.