[Primary transmaxillary buccopharyngectomy and recovery transmaxillary buccopharyngectomy in giant cancers of the tonsilar region. Apropos of 120 cases].

Based on a series of 120 patients treated by trans-maxillary buccopharyngectomy for tumors (mainly T3, T4) of the tonsillar region, results are compared of primary and recovery surgery, the latter being instituted from 1981 because of the rapid strides made in new reconstructive procedures. This development markedly modified therapeutic indications, with substitution of radiotherapy as primary treatment. After primary surgery, the 3- and 5-year survival rates were globally 59 and 49% respectively. The usual prognostic factors emphasized, size of tumor and glandular involvement, were verified. Results of recovery surgery were less good, 39% survival at 3 years, for two main reasons: a higher level of lack of local control (34%) than that of primary surgery (14%) and a maintained elevated postoperative mortality. These findings indicate that the initial hope that the use of LMC would raise this surgery to the level of the performance of primary surgery has not been fully confirmed. Finally, analysis of all groups in this series demonstrates that prognosis is worse as the involvement of base of tongue increases.