High-Risk Cutaneous Squamous Cell Carcinoma: A Review for Dermatologists on Definition, Risk Factors, Clinical Staging, and Management
Résumé
Cutaneous squamous cell carcinoma (cSCC) is a common cutaneous malignancy with an increasing incidence that is highly treatable with excellent outcomes in most cases. The goal of this review is to arm the dermatologist with the broad clinical information needed to identify and/or appropriately treat the smaller subset of cSCCs that are high risk and contribute to disease specific morbidity and mortality. Key topics include defining high-risk Squamous cell carcinoma (SCC) risk factors, staging, lymph node assessment, and management strategies. Management of mucosal, locally advanced, and metastatic SCC are beyond the scope of this review.
Références
Guzman AK, Schmults CD, Ruiz ES. Squamous cell carcinoma: an update in staging, management and postoperative surveillance strategies. Dermatol Clin. 2023;41(1):1-11. doi:10.1016/j.det.2022.07.004
de Jong E, Lammerts MUPA, Genders RE, Bavinck JNB. Update on advanced cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol. 2022;36 Suppl 1(Suppl 1):6-10. doi:10.1111/jdv.17728
Soura E, Gagari E and Stratigos A. Advanced cutaneous squamous cell carcinoma: how is it defined and what new therapeutic approaches are available? Curr Opin Oncol. 2019;31(5):461-468. doi:10.1097/CCO.0000000000000566
Cheng J, Yan S. Prognostic variables in high-risk cutaneous squamous cell carcinoma: a review. J Cutan Pathol. 2016;43(11):994-1004. doi:10.1111/cup.12766
Fox M, Brown M, Golda N, Goldberg D, Miller C, Pugliano-Mauro M, et al. Nodal staging of high-risk cutaneous squamous cell carcinoma. J Am Acad Dermatol. 2019;81(2):548-557. doi:10.1016/j.jaad.2018.09.006
Stevens JS, Murad F, Smile TD, O’Connor DM, Ilori E, Koyfman S, et al. Validation of the 2022 National Comprehensive Cancer Network risk stratification for cutaneous squamous cell carcinoma. JAMA Dermatol. 2023;159(7):728-735. doi:10.1001/jamadermatol.2023.1353
Borgognoni L, Susini P, Gerlini G, Brandani P, Giannotti V, Sestini S. Sentinel lymph node biopsy: is there a role in non-melanoma skin cancer? A systematic review. Cancers (Basel). 2024;16(24):4279. doi:10.3390/cancers16244279
Skulsky SL, O’Sullivan B, McArdle O, Leader M, Roche M, Conlon PJ, et al. Review of high-risk features of cutaneous squamous cell carcinoma and discrepancies between the American Joint Committee on Cancer and NCCN Clinical Practice Guidelines In Oncology. Head Neck. 2017;39(3):578-594. doi:10.1002/hed.24580
Tokez S, Koekelkoren FHJ, Baatenburgde Jong RJ, Grünhagen DJ, Mooyaart AL, et al. Assessment of the diagnostic accuracy of baseline clinical examination and ultrasonographic imaging for the detection of lymph node metastasis in patients with high-risk cutaneous squamous cell carcinoma of the head and neck. JAMA Dermatol. 2022;158(2):151-159. doi:10.1001/jamadermatol.2021.4990
Beach SC, Cusick AS, Farberg AS, Trotte SC. A comprehensive narrative review of the challenges surrounding cutaneous SCC. Dermatol Ther (Heidelb). 2025;15(8):2015–2029. doi:10.1007/s13555-025-01470-7
Newman JG, Hall MA, Kurley SJ, Cook RW, Farberg AS, Geiger JL, et al. Adjuvant therapy for high-risk cutaneous squamous cell carcinoma:10-year review. Head Neck. 2021;43(9):2822-2843. doi:10.1002/hed.26767
Mirali S, Tang E, Drucker AM, Turchin I, Gooderham M, Levell N, et al. Follow-up of patients with keratinocyte carcinoma a systematic review of clinical practice guidelines. JAMA Dermatol. 2023;159(1):87-94. doi:10.1001/jamadermatol.2022.4590
