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This is an analysis of 25 patients with carcinoma of the skin of the head and neck with clinical evidence of perineural invasion, who were managed with curative intent by radiotherapy alone (16) or surgery and radiotherapy (9). All patients had a minimum of 5 years of follow-up. Local control following treatment was observed in 20% of patients treated with radiotherapy alone and 38% of those treated with surgery and radiotherapy. Local control was diminished for recurrent lesions and for tumors that also invaded bone and/or cartilage. The 5-year absolute survival rates were 31% for patients treated with radiotherapy alone and 33% for those in the combined-treatment group. The incidence of significant complications was similar: 25% with radiotherapy alone and 33% with surgery and adjuvant radiotherapy.

Two hundred and eighty patients with previously untreated large bowel adenocarcinoma were retrospectively evaluated following complete primary resection to determine patterns of recurrence. One hundred and five patients (37%) subsequently developed recurrent disease. Sixty percent (63/105) presented with local recurrence alone, 14% (15/105) with concomitant local recurrence and distant metastases, and 26% (27/105) with distant metastases alone. Ninety-two percent of local recurrences developed in structures contiguous to the operative area of the incision. The degree of tumor anaplasia and depth of tumor penetration into the bowel wall influenced the rate of local recurrence. Through 5 years, local recurrence without clinical evidence of distant metastases was the most common cause of death. Plans for adjuvant radiation therapy are discussed.