Craniofacial surgery for nonmelanoma skin malignancy: report of an international collaborative study

Head Neck. 2007 Dec;29(12):1136-43. doi: 10.1002/hed.20656.


Background: This study examined the efficacy of craniofacial surgery (CFS) in treating locally advanced nonmelanoma skin cancer (NMSC).

Methods: One hundred twenty patients who underwent CFS for NMSC were identified from 17 participating institutions. Patient, tumor, and treatment information was analyzed for prognostic impact on survival.

Results: Surgical margins were negative in 74%, close in 3%, and involved in 23% of patients. Complications occurred in 35% of patients, half of which were local wound problems. Operative mortality was 4%. Median follow-up interval after CFS was 27 months. The 5-year overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) rates were 64%, 75%, and 60%, respectively. Squamous cell histology, brain invasion, and positive resection margins independently predicted worse OS, DSS, and RFS.

Conclusion: CFS is an effective treatment for patients with NMSC invading the skull base. Histology, extent of disease, and resection margins are the most significant predictors of outcome.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brain Neoplasms / mortality
  • Brain Neoplasms / secondary
  • Brain Neoplasms / surgery
  • Carcinoma, Basal Cell / mortality
  • Carcinoma, Basal Cell / pathology
  • Carcinoma, Basal Cell / surgery
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / surgery
  • Chemotherapy, Adjuvant
  • Child
  • Child, Preschool
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • International Cooperation
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Postoperative Complications
  • Radiotherapy, Adjuvant
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / surgery
  • Skull Neoplasms / mortality
  • Skull Neoplasms / secondary*
  • Skull Neoplasms / surgery*
  • Surgical Flaps