Surgery can have enormous impact on QOL. If radiation and chemo can knock it down, that means you get to keep your tongue, swallow, talk, and so much more.

Surgery for the very small and early or for salvage of the really bad is the most common approach. If rad and chemo don't do the trick, surgery is now less aggressive, since the tumor is smaller from the previous treatments. Cutting away less of those needed structures that you can't (for the most part) put back.