title: Craniofacial surgery for nonmelanoma skin malignancy: report of an international collaborative study.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Head and Neck Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors.forename: Ellie G
authors.initials: EG
authors.lastname: Maghami
authors.forename: Simon G
authors.initials: SG
authors.lastname: Talbot
authors.forename: Snehal G
authors.initials: SG
authors.lastname: Patel
authors.forename: Bhuvanesh
authors.initials: B
authors.lastname: Singh
authors.forename: Ashok
authors.initials: A
authors.lastname: Polluri
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Bridger
authors.forename: Giulio
authors.initials: G
authors.lastname: Cantu
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Cheesman
authors.forename: Geraldo
authors.initials: G
authors.lastname: De Sa
authors.forename: Paul
authors.initials: P
authors.lastname: Donald
authors.forename: Luiz R M
authors.initials: LR
authors.lastname: dos Santos
authors.forename: Dan
authors.initials: D
authors.lastname: Fliss
authors.forename: Patrick
authors.initials: P
authors.lastname: Gullane
authors.forename: Ivo
authors.initials: I
authors.lastname: Janecka
authors.forename: Shin-Etsu
authors.initials: SE
authors.lastname: Kamata
authors.forename: Luiz P
authors.initials: LP
authors.lastname: Kowalski
authors.forename: Dennis H
authors.initials: DH
authors.lastname: Kraus
authors.forename: Paul A
authors.initials: PA
authors.lastname: Levine
authors.forename: Sultan
authors.initials: S
authors.lastname: Pradhan
authors.forename: Victor
authors.initials: V
authors.lastname: Schramm
authors.forename: Carl
authors.initials: C
authors.lastname: Snyderman
authors.forename: William I
authors.initials: WI
authors.lastname: Wei
authors.forename: Jatin P
authors.initials: JP
authors.lastname: Shah
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary / Q000601:surgery; D002280:Basal Cell Carcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007391:International Cooperation; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011183:Postoperative Complications; D018714:Radiotherapy, Adjuvant; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D012888:Skull Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D013524:Surgical Flaps