An analysis of the clinical management of recurrent tumor after composite resection in forty-five patients is presented. The results indicate that the time interval between recurrence and the presence or absence of lymph node metastasis in the operative specimen are the most reliable indications for further attempts at palliation or cure. Effective palliation was obtained in 70 per cent of those patients without histologic evidence of lymph node metastasis in the operative specimen and in whom recurrence was detected at least fifteen months after the operative procedure. In contrast, effective palliation was obtained in only 4.3 per cent of the patients who had evidence of lymph node metastasis in the operative specimen and in whom recurrence developed in less than fifteen months.
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