The American Society of Therapeutic Radiologists Presidential Address: October 1981. Potential for improving survival rates for the cancer patient by increasing the efficacy of treatment of the primary lesion.

The potential impact on survival probability for the cancer patient of elimination of local failure of treatment was considered. Clinical data demonstrate that for several sites salvage treatment (surgery or radiation) yields eminently worthwhile survival figures for carefully selected patients with local persistence or regrowth of tumor. These long-term disease-free survivals constitute proof that elimination of local failures would result in some increase in survival rate. The increases in survival of patients with carcinoma at four sites by employing a new treatment method which yields a 100% local control rate (and no fatal complications) were estimated by assuming that the rates of death due to distant metastasis and intercurrent disease among patients who achieved an uncomplicated control of their primary disease by the conventional treatment would apply to the patients achieving local control by a new method. The number of additional survivors in the U. S. cancer population was conservatively estimated for these sites to be: uterine cervix, 2700; orocavity and oropharynx, 2000; ovary, 2100; and colorectum, 17000. Analyses have not been completed for other sites. These predicted increases of survivors due to improved local treatment methods are greater than would be predicted by improving treatment of distant disease, for patients with carcinoma of the uterine cervix and of the orocavity and oropharynx.