Craniofacial Resection for Advanced Cutaneous Squamous Cell Carcinoma: Results From the 2nd International Collaborative Case‐Series
BACKGROUND: Robust outcome data for anterior skull base cutaneous squamous cell carcinoma (cSCC) are limited, particularly as emerging therapies reshape management. We evaluated survival and prognostic factors following craniofacial resection. METHODS: Retrospective multi-institutional case-series (1995-2015) of patients who underwent skull base surgery for anterior face/scalp cSCC. Kaplan-Meier and Cox regression analyses assessed disease-free (DFS), disease-specific (DSS), and overall survival (OS). RESULTS: Among 112 patients, most had T4 (86.6%) and recurrent (71.4%) disease. Clear margins were achieved in 32.1%; 40.2% were involved. Five-year DFS, DSS, and OS were 46.9%, 68.4%, and 52.3%, respectively. Intracranial extension independently predicted worse OS (HR:6.54 [95% CI:2.61,16.38]) and DSS (HR:12.39 [95% CI:2.72,56.45]). Involved margins predicted recurrence on univariable analysis. Adjuvant therapy, predominantly post-operative radiotherapy, improved OS (HR: 0.54 [95% CI: 0.30,0.97]). Complications occurred in 38.4%, with 4.5% perioperative mortality. CONCLUSION: Advanced anterior skull base cSCC carries substantial morbidity and modest survival. These data provide a benchmark against which immunotherapy-based strategies should be evaluated.
Authors
- Ian Witterick (ORCID: https://orcid.org/0000-0001-5612-481X)
- Cesare Piazza (ORCID: https://orcid.org/0000-0002-2391-9357)
- Subramania Iyer (ORCID: https://orcid.org/0000-0003-1440-4500)
- Gregorio Sánchez Aniceto (ORCID: https://orcid.org/0000-0002-9667-336X)
- Shirley Y. Su (ORCID: https://orcid.org/0000-0002-3903-8204)
- Benedict Panizza (ORCID: https://orcid.org/0000-0002-3724-3773)
- Jatin P. Shah (ORCID: https://orcid.org/0000-0002-6444-6592)
- Cláudio Roberto Cernea (ORCID: https://orcid.org/0000-0001-5899-0535)
- Serdar Özer (ORCID: https://orcid.org/0000-0003-1669-8020)
- Catherine Rennie (ORCID: https://orcid.org/0000-0002-1580-5296)
- Álvaro Rivero Calle (ORCID: https://orcid.org/0000-0003-2396-7073)
- Ph H
- Luiz Paulo Kowalski (ORCID: https://orcid.org/0000-0002-0481-156X)
- Rodney J. Schlosser (ORCID: https://orcid.org/0000-0001-6480-0275)
- Richard J. Harvey (ORCID: https://orcid.org/0000-0002-6942-8975)
- Mithat Gönen (ORCID: https://orcid.org/0000-0001-8683-8477)
- Sérgio Gonçalves (ORCID: https://orcid.org/0000-0001-6742-608X)
- Ronaldo Nunes Toledo (ORCID: https://orcid.org/0000-0002-5576-9808)
- Wojciech Golusiński (ORCID: https://orcid.org/0000-0002-6075-3464)
- Lillian A. Boe (ORCID: https://orcid.org/0000-0001-6279-9987)
- Ken‐ichi Nibu (ORCID: https://orcid.org/0000-0002-5461-4871)
- Se‐Heon Kim (ORCID: https://orcid.org/0000-0002-6407-5859)
- Marc A. Cohen (ORCID: https://orcid.org/0000-0002-6104-7967)
- Walter Fontanella (ORCID: https://orcid.org/0000-0003-3547-1331)
- C. René Leemans (ORCID: https://orcid.org/0000-0001-7887-083X)
- Ian Ganly (ORCID: https://orcid.org/0000-0001-7636-5426)
- Cristina Valero (ORCID: https://orcid.org/0000-0003-3397-2888)
- Ehab Y. Hanna (ORCID: https://orcid.org/0000-0003-3241-2440)
- Snehal G. Patel (ORCID: https://orcid.org/0000-0001-9775-5132)
- Alana J. Eagan (ORCID: https://orcid.org/0009-0006-4987-7104)
- Franco DeMonte (ORCID: https://orcid.org/0000-0002-6488-3645)
- John R. de Almeida (ORCID: https://orcid.org/0000-0002-1546-5033)
- Fernando Luiz Dias (ORCID: https://orcid.org/0000-0003-1000-7436)
- Luis Alejandro Boccalatte (ORCID: https://orcid.org/0000-0002-0096-418X)
- Marcelo Figari (ORCID: https://orcid.org/0000-0003-3760-7503)
- Jan Hendrickx (ORCID: https://orcid.org/0009-0000-9846-0408)
- Michael Schachtel (ORCID: https://orcid.org/0000-0002-1111-3946)
- Helena Levyn (ORCID: https://orcid.org/0009-0005-4402-6186)
- Fang Ju Gao
- Catherine Barnett (ORCID: https://orcid.org/0009-0009-5051-1750)
- P. Clarke
- Yiming Zhu (ORCID: https://orcid.org/0000-0002-1267-2897)
- Prathamesh Pai
- Şefik Hoşal (ORCID: https://orcid.org/0009-0005-1452-2226)
- Shahzada Ahmed
- Paolo Castelnuovo
- Dauren Adilbay
- Zoukaa Sargi
- Dan M. Fliss
- Shaan M. Raza
- Junting Zheng
- Piero Nicolai
- James J. Bowman
Institutions
- University of Insubria (IT)
- Poznan University of Medical Sciences (PL)
- Amrita Institute of Medical Sciences and Research Centre (IN)
- Beijing Tongren Hospital (CN)
- Memorial Sloan Kettering Cancer Center (US)
- The University of Texas MD Anderson Cancer Center (US)
- Medical University of South Carolina (US)
- Imperial College Healthcare NHS Trust (GB)
- The University of Queensland (AU)
- University of Nicosia (CY)
- University of Milan (IT)
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- Université Paris Cité (FR)
- Tata Memorial Hospital (IN)
- Princess Alexandra Hospital (AU)
- Hospital Italiano de Buenos Aires (AR)
- Charing Cross Hospital (GB)
- Princess Margaret Cancer Centre (CA)
- AC Camargo Hospital (BR)
- UNSW Sydney (AU)
- Research Institute Hospital 12 de Octubre (ES)
- Instituto do Câncer do Estado de São Paulo (BR)
- Institute of Health Services and Policy Research (CA)
- Amsterdam Neuroscience (NL)
- Hôpital Lariboisière (FR)
- Sinai Health System (CA)
- NIHR Surgical Reconstruction and Microbiology Research Centre (GB)
- Instituto Nacional de Câncer - INCA (BR)
- Institute for Work & Health (CA)
- Amsterdam University Medical Centers (NL)
- Sylvester Comprehensive Cancer Center (US)
- Yonsei University Health System (KR)
- Atilim University (TR)
- Kobe University (JP)
- Hacettepe University (TR)
- University of Brescia (IT)
- Macquarie University (AU)
Publication Details
- Journal
- Head & Neck
- Published
- 2026-07-27
- DOI
- https://doi.org/10.1002/hed.70412
- Primary Topic
- Nonmelanoma Skin Cancer Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- University of Queensland