Evaluation of the Definitions of “High-Risk” Cutaneous Squamous Cell Carcinoma Using the American Joint Committee on Cancer Staging Criteria and National Comprehensive Cancer Network Guidelines

Table 2

Abbreviated list of NCCN “high-risk” factors.

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NCCN “high-risk” factors

 Area M ≥ 10 mm

 Area H ≥ 6 mm

 Poorly defined

 Recurrence

 Immunosuppression

 Site of prior RT or chronic inflammatory process

 Rapidly growing tumor

 Neurologic symptoms

Pathology

 Moderately or poorly differentiated histology

 Acantholytic, adenosquamous, or desmoplastic subtypes

 Depth: ≥2 mm or Clark levels IV, V

 Perineural or vascular involvement

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Tumor is “high-risk” if ≥1 of 12 risk factors.
M = “medium” risk: forehead, scalp, cheek, neck.
H = “high” risk: “mask areas of the face” central face, ears, periauricular, eyelids, periorbital, nose, temple, and lips.
Note: The study cohort in this analysis was based on cSCCs from the head and neck only. Risk factors and specifics regarding tumors on Area L (“low” risk anatomic site: trunk and extremities), hands/feet, genitalia are not listed.