The present investigation of a retrospective series of patients with tongue cancers aimed at assessing the results of various treatment principles. We suggest that surgery must be taken into account particularly when large primary tumors as well as palpable regional nodes are found. Because of the unpredictable metastasis behavior, even in cases of small primary tumors without clinical evidence of regional spread, the potential risk of regional microdeposits must always be suspected. Therefore, irradiation of the neck field with fractionated doses of 5,000 rad, alone or in combination with surgery should be considered in all patients with tongue cancers.