[Cancers of the soft palate. Results of repeat surgery]

Between 1960 and 1983, 270 patients were treated at the CURIE Institute for a carcinoma of the soft palate, including 260 by radiotherapy (mean dose: 69 Gy). Most of these tumours were T1 T2 (201 cases, 76%). There was a high frequency of a past history of carcinoma (38 cases, 14%) as well as of simultaneous carcinomas (44 cases, 16%). Two months after radiotherapy, a velar tumor persisted in 29 patients whilst 1 patient had deep necrosis. 15 of these 30 patients underwent secondary surgical excision. This surgical series included 25 of 27 recurrences seen secondarily and 6 patients operated on for second velar carcinoma appearing in the irradiated zone (mean dose: 68 Gy). 45 of the 46 excisions were carried out by a buccal approach. Overall survival after surgery was 32% at 3 years. The 11 patients operated on for an extensive T3 T4 tumour died before 12 months. These poor results were related to the frequency of local recurrences (12 loco-regional failures amongst 36 deaths) as well as the number of deaths due to second carcinomas (11 deaths amongst the surgical patients). Later carcinomas were particularly frequent during the course of tumours of this site (69 cases out of 270), the problem of multiple malignant tumours finally affecting 122 patients out of 270, i.e. 45%.