Surgery vs chemotherapy plus surgery for carcinoma of the head and neck

We reviewed the results of standard therapy (surgery +/- radiation therapy) in 66 patients with advanced resectable head and neck cancer treated between 1984 and 1988 and compared them with a "historical" group of similar resectable patients treated between 1978 and 1984, by induction chemotherapy followed by standard therapy. The median disease-free survival of patients treated by surgery was 18 months, whereas it had not been reached in those receiving chemotherapy. When 2-year disease-free survival was compared according to stage and site, patients receiving chemotherapy fared better. The recurrence rate of all patients receiving chemotherapy was less than half of those receiving standard treatment only. A higher percentage of patients receiving chemotherapy survived their original tumor, only to die of second malignancies, most of these occurring elsewhere in the aerodigestive tract.