riSCC: A personalized risk model for the development of poor outcomes in cutaneous squamous cell carcinoma - 18/06/25

Doi : 10.1016/j.jaad.2025.02.076

Anokhi Jambusaria-Pahlajani, MD, MSCE ^a, Vincent Jeanselme, PhD ^b, David M. Wang, MD ^c, Nina A. Ran, MD, MS ^c, Emily E. Granger, MD ^d, Javier Cañueto, MD ^e, David G. Brodland, MD ^f, David R. Carr, MD, MPH ^g, Joi B. Carter, MD ^h, John A. Carucci, MD, PhD ⁱ, Kelsey E. Hirotsu, MD ^j, Emily E. Karn, MS ^c, Shlomo A. Koyfman, MD ^k, Aaron R. Mangold, MD ^l, Fabio Muradás Girardi, MD, MSc ^m, Kathryn T. Shahwan, MD ^g, Divya Srivastava, MD ⁿ, Allison T. Vidimos, RPh, MD ^o, Tyler J. Willenbrink, MD ^f, Ashley Wysong, MD, MS ^p, William Lotter, PhD ^q, Emily S. Ruiz, MD, MPH ^c,^⁎

^a Division of Dermatology, University of Texas, Austin, Texas

^b MRC Biostatistics Unit, University of Cambridge, Cambridge, UK

^c Department of Dermatology, Brigham and Women's Hospital, Boston, Massachusetts

^d Department of Dermatology, University of Maryland School of Medicine, Baltimore, Maryland

^e Department of Dermatology, Complejo Asistencial Universitario de Salamanca, Salamanca, Spain

^f Zitelli and Brodland P.C., Pittsburgh, Pennsylvania

^g Department of Dermatology, The Ohio State University Medical Center, Columbus, Ohio

^h Department of Dermatology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire

ⁱ Department of Dermatology, New York University School of Medicine, New York, New York

^j Department of Dermatology, Stanford School of Medicine, Palo Alto, California

^k Department of Radiation Oncology, Cleveland Clinic, Cleveland, Ohio

^l Department of Dermatology, Mayo Clinic Arizona, Scottsdale, Arizona

^m Department of Head and Neck Surgery, Ana Nery Hospital, Santa Cruz do Sul, RS, Brazil

ⁿ Department of Dermatology, University of Texas Southwestern School of Medicine, Dallas, Texas

^o Department of Dermatology, Cleveland Clinic, Cleveland, Ohio

^p Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska

^q Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts

^∗ Correspondence to: Emily S. Ruiz, MD, MPH, Department of Dermatology, Brigham and Women's Hospital, 1153 Centre St, Suite 4J, Boston, MA 02130. Department of Dermatology Brigham and Women's Hospital 1153 Centre St, Suite 4J Boston MA 02130

Abstract

Background

Cutaneous squamous cell carcinoma (CSCC) is a prevalent disease for which improved risk stratification strategies are needed.

Objective

To develop a novel prognostic model (herein “riSCC”) for CSCC and compare riSCC performance to Brigham and Women's Hospital and American Joint Committee on Cancer Staging eighth edition T staging systems.

Methods

Retrospective 12-center, multinational cohort study of CSCCs from 1991 to 2023. Clinical and pathologic risk factors, treatments, and outcomes were collected. Fine-Gray model was employed for each outcome with inverse probability of treatment weighting. A final model was trained for prospective use and estimation of hazard ratios.

Results

Twenty-three thousand one hundred sixty-six localized CSCC tumors were included. riSCC prognostic model performed superiorly to American Joint Committee on Cancer eighth edition and Brigham and Women's Hospital T staging for all outcomes. At 5 years, the C-index for riSCC ranged from 0.74 for local recurrence to 0.87 for disease specific death.

Limitations

Retrospective study design.

Conclusion

riSCC prognostic model offers fine-grained risk estimates and improved stratification for important CSCC outcomes compared to T staging systems.

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Key words : American Joint Committee on Cancer eighth edition, Brigham and Women's Hospital T Staging, cutaneous oncology, cutaneous squamous cell carcinoma, metastasis, Mohs micrographic surgery, nonmelanoma skin cancer, oncology, outcomes, recurrence

Abbreviations used : AJCC8, BWH, CSCC, DSD, ITM, LR, LVI, MMS, NM, PNI, WLE

Mappa

Introduction

Methods

Development of cohort and data collection

Statistical analysis

Development of application

Results

Discussion

	Drs Jambusaria-Pahlajani, Ruiz and Authors Jeanselme, Lotter are contributed equally.
	Funding sources: Supported in part by the American College of Mohs Surgery (ACMS) Foundation ; WL is supported by grant R21EB035247 .
	Patient consent: Not applicable.
	IRB approval status: Reviewed and approved by all 12 institutions.

Esportazione

Vol 93 - N° 1

P. 73-81 - luglio 2025 Ritorno al numero

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riSCC: A personalized risk model for the development of poor outcomes in cutaneous squamous cell carcinoma - 18/06/25

Abstract

Background

Objective

Methods

Results

Limitations

Conclusion

Mappa

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