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The authors report their experience on six male patients and one female patient (age range: 58–76 years, median: 67) with facial tumours involving the anterior skull base, undergoing craniofacial resection between January 1992 and May 1994 at the Division of Surgical Oncology in the Tumor Institute, Genoa. Three patients had squamous carcinom and adenocarcinoma of the nasal fossa; two patients had squamous carcinoma rT4NO and adenocarcinoma rT4NO 1 of the maxillary sinus; one patient had squamous carcinoma of the eyelid, and another had squamous carcinoma of the internal chantus. Four patients had had previous radiotherapy, another underwent pre-operative chemoradiotherapy, and only two patients had not been treated before. A proper craniofacial tumour resection was performed in three patients; one patient had a left maxillectomy with ethmoidectomy and orbital exenteration; one patient underwent maxillectomy, resection of the medial and inferior wall of the orbit, ethmoidectomy, and orbital exenteration; one patient underwent maxillectomy, ethmoidectomy, and mucosectomy of the sphenoidal sinus, and one patient had total ethmoidectomy. As for reconstruction procedures of the anterior skull base, lyophilized dura with galeal pericranial flap was commonly used. A myocutaneous flap transposition (transverse rectus abdominis and latissimus dorsi myocutaneous flap) was used in two patients for the reconstruction of the resected tissues and bones of maxillary and orbital regions. Post-operative complications included intraoperative liquorrhea in one patient; one case of early and serious pneumocephalus; flap necrosis occurred following transposition of latissimus dorsi. Median hospital stay was 34 days. After a median follow-up of 18 months (range: 3 to 34 months) five of seven patients (71.4%) are alive and disease-free at 15, 17, 18, 30 and 34 months from surgery.

From May 1985 to June 1992, 375 patients (pts) were enrolled in a prospective controlled randomized clinical trial of periop adjuvant chemotherapy (PAC) associated to long-term adjuvant chemoendocrinotherapy in order to test the effectiveness of reducing the time interval between surgery and chemotherapy. Here, the short-term surgical complications related to PAC are reported in order to verify whether such treatment might negatively affect the results of breast cancer surgery. Pts undergoing PAC received with in 48–72 hour following surgery one course of CY (600 mg/sqm), EPI (60 mg/sqm), and 5-FU (600 mg/sqm) (CEF): pN+ pts, who were given perioperative CEF, had five further cycles of CEF alternated with six cycles of CMF (CY 600 mg/sqm, MTX 40 mg/sqm, 5-FU 600 mg/sqm). All other pN+ pts had six cycles of CEF alternated with six cycles of CMF, starting with in 30 days after surgery. No significant difference of postop morbidity was observed in the two groups as regards median hospital stay (8 days), number of out patient dressings (3.5 vs 3), seroma (51 = 26.9% vs 45 = 24.2%), lymphatic drainage (400 vs 409 ml), and postop infections, both local (10 vs 9) and in extraop foci (6 vs 7). The toxicity of the periop CEF was mainly gastrointestinal (nausea and vomiting 55%, stomatitis 3%), with only a small percentage (9%) reaching grade III–IV.