In my practice, the decision to re-resect vs RT in patients with close margins or high grade dysplasia depends on the ability to identify and reliably resect close or dysplastic margins without risk of oral incompetence. 

With all due respect to our surgical colleagues, it takes more time, certainly, there is more swelling and lip pain during radiation, but our functional and cosmetic results are much better with primary radiation.

While re-excision is a viable option, cosmesis and verbal understanding are also critical. Once the decision is made for radiation, a really nice option one not practiced as often these days is brachytherapy. Literature supports great results for tumor control but also for side effects and excellen...