Review of charts of 158 patients with carcinoma of the oral tongue revealed 108 (68 percent) were clinically free of cervical metastasis upon presentation. Patients who were found to have microscopic metastases after elective neck dissection and patients who developed cervical metastases but never a local recurrence were said to have occult regional metastases. The incidence of occult metastases was 23 percent with no difference between T1, T2, and T3 lesions. Determinant survival rates of the T1N0M0 groups were 83 percent and 57 percent at two and five years respectively. Survival rates of the T1N0M0 patients who had occult metastases were comparable (82 percent and 50 percent respectively). Survival rates of patients with T2N0M0 and T3N0M0 lesions with occult metastases were lower than for all patients in each of the two groups. The incidence of local recurrence in these same 108 patients was 27 percent with the incidence highest in the T2N0M0 group (31 percent). Survival rates of these patients, especially of those who developed regional metastases, were lower in all three groups of patients. The combined use of pre‐operative irradiation with cobalt 60 followed by en bloc resection of the primary tumor with the regional lymphatics has been very effective to date. The following conclusions are based on retrospective study of carcinoma of the oral tongue. The incidence of occult regional metastasis is the same for T1 and T2 primary cancers of the oral tongue. To date, combined therapy is resulting in higher survival rates in patients with larger oral tongue carcinomas. To increase the probability of cure, elective treatment of regional lymphatics either by radical neck dissection or irradiation should be considered in the treatment of T1N0M0 epidermoid carcinoma of the oral tongue.

Although biliary complications occur somewhat frequently, central bisectionectomy in centrally located HCC can be performed safely to preserve liver volume.