Surgery versus combined therapies for cancer of the anterior floor of the mouth

We report the results of treatment in a consecutive series of 75 patients operated on at the Istituto Nazionale Tumori of Milan, from January 1965 to December 1979, for cancer of the anterior floor of the mouth. Most of the tumors were advanced: 39 were treated with simple resection, and 36 underwent combined treatment, consisting of surgery associated with either chemotherapy or surgery. Three- and five-year observed survival rates of the whole series were good (41% and 25%, respectively), considering the tumor stage of these patients, but the determined survival rates were particularly high (56% and 46%, respectively). No real advantage was found in the use of multiple planned sequential therapies over surgery alone, and deaths from intercurrent diseases seemed to be more frequent in the patients who underwent combined therapies. We conclude that for patients in poor general condition, such as those with carcinomas of the anterior floor of the mouth, aggressive and complex treatments should be considered with caution in controlled clinical trials.