Operative Therapy for Skin Cancer on the Head and Neck

Abstract

The operative therapies we have actually performed and the prognoses of the skin cancers and the precancerous conditions we have experienced in the past ten and some years (mostly squamous cell carcinoma and basalioma; several of meibomian gland carcinoma, fibrosarcoma and dermatofibrosarcoma protuberans, respectively) have been stated. It is necessary to consider postoperative cosmetic aspects carefully as well as eradicative effects, since head and neck most easily attract attention. For this purpose one is requrired to have full knowledge of operative procedures appropriate for the characteristics of each site— head, forehead, periorbital region, nose, perioral region, ear and so on. As it is for the skin cancer on the other parts of the body, it is desirable to perform operative therapy in the stage where metastasis to lymph nodes is not yet observed (stage ITN0M0). In cases that already have metastasis to the regional lymph nodes (NI-3), it is advisable to carry out radical neck dissection vigorously. For there has been a considerable difference in prognosis between the cases with dissection and those without. As to the cases that have the primary lesions of T3-4 and have somewhat questionable radicality on operative therapy, and as to those that are NI-3 and their radical dissection may not be done perfectly, it is prefarable, in order to improve prognosis, to positviely combine postoperative radiation therapy such as betatron for the former and ⁶⁰Co for the latter. For multiple senile keratoma on the face, multiple Bowen’s disease on the body and the extremities, and xeroderma pigmentosum in the second and the early third stage, skin abrasion technique is recommended, which at the same time can renew the skin.