Navigating the Future of Cutaneous Squamous Cell Carcinoma (cSCC): An Expert Discussion on Modern Immunotherapy - Episode 2

Assessing Risk in cSCC: Key Clinical and Pathologic Markers

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Panelists discuss clinical and pathological factors used to stratify cSCC into low-, high-, and very high-risk categories.

Panelists explain that tumor risk stratification is central to determining treatment intensity and follow-up schedules. High-risk features include greater tumor diameter, increased depth of invasion, poor differentiation, and perineural or lymphovascular involvement. Location also matters—lesions on the ear, lip, or scalp tend to have more aggressive behavior.

Pathologic parameters such as desmoplastic histology or invasion beyond subcutaneous fat correlate strongly with recurrence or metastasis. The use of staging systems and guideline-based checklists has standardized risk assessment across specialties, helping clinicians communicate effectively and plan treatment.

They conclude that early recognition of high-risk features prompts multidisciplinary collaboration, appropriate imaging, and timely escalation of care—key steps in preventing local recurrence or regional spread.