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June 1972

The Composite Operation in Cancer of the Head and Neck (Commando Procedure)

Author Affiliations

Duarte, Calif
From the Department of General and Oncologic Surgery, City of Hope National Medical Center, Duarte.

Arch Surg. 1972;104(6):809-813. doi:10.1001/archsurg.1972.04180060059015

During the last 16 years, 130 patients were treated with the radical composite operation (commando procedure) for extensive malignancies of the oropharyngeal cavity. All but two patients had invasive squamous cell carcinoma. The primary tumor was localized in the floor of the mouth in 37% of the patients, mandibular ridge and gingiva in 24%, and tongue in 18%. The operative mortality was 1.5%. The main complications were oro-cutaneous fistula and infection. The three-year survival was 38.6% and the five-year survival was 23%. Main reasons for failure were local recurrence noted in 43 patients and distant metastasis to organs of the chest and abdomen in 11 patients. Of interest was a second primary to the esophagus remote from the primary site seen in six patients.