Recent investigations have questioned the efficacy of a combined therapy regimen with irradiation. The purpose of this study was to compare the survivals with surgery alone versus combined therapy (pre-op irradiation) and to analyze any apparent differences to identify the source (s) of failure. Two and five-year determinate survivals for this group were found to be significantly better for surgery alone. There is no instance where combination therapy is found to be statistically superior. An analysis of treatment failures showed that distant metastases occurred at a greater rate in the combined therapy patients than they did with those treated by surgery alone. The advisability of combined therapy using preoperative irradiation with its increased cost and morbidity to the patient is questioned if it does not improve survival over surgery used as a single modality.