title: Surgical management of giant nonmelanoma skin neoplasia.
abstract: BACKGROUND
  Management of advanced integumentary malignancy has been controversial. We have evaluated and treated 10 patients with giant nonmelanoma skin neoplasias more than 8 cm in diameter.
  
  
  METHODS
  Aggressive surgical ablation was prospectively recommended to treat giant basal cell or mixed basosquamous tumors and two purely squamous cell tumors. Radiation therapy was given in three surgical patients. Our data are analyzed retrospectively.
  
  
  RESULTS
  Survival of the two patients who refused surgery was measured in weeks. One patient who refused adequate surgery survived 9 months before dying. All of the adequately treated surgical patients are alive as of this writing, including one who had subsequent resection of pulmonary metastases. Three patients required free tissue transfer. The average survival of surgically treated patients was 2.7 years.
  
  
  CONCLUSIONS
  An aggressive surgical approach to the management of advanced/giant skin neoplasia is justifiable and the only treatment that may produce long-term survivability.
authors.affiliation: Department of Surgery, University of South Alabama College of Medicine, Mobile, USA.
authors.forename: W O
authors.initials: WO
authors.lastname: Thomas
authors.forename: L L
authors.initials: LL
authors.lastname: Harper
authors.forename: S G
authors.initials: SG
authors.lastname: Wong
authors.forename: C N
authors.initials: CN
authors.lastname: Harris
authors.forename: J A
authors.initials: JA
authors.lastname: Parker
authors.forename: J
authors.initials: J
authors.lastname: Abernethy
authors.forename: B
authors.initials: B
authors.lastname: Murphy
authors.forename: R
authors.initials: R
authors.lastname: Harrington
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002281:Carcinoma, Basosquamous / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate