Gupta N, Weitzman RE, Murad F, et al. - Findings demonstrate an 8% likelihood of developing poor outcomes in Brigham and Women’s Hospital (BWH) T2a-high cutaneous squamous cell carcinomas (CSCCs).

• In this 17-year retrospective multi-institutional cohort analysis of primary CSCC BWH T2a tumors, a predictive model based on tumor features was constructed to detect those at higher risk of poor outcomes.

• Having 1 major and ≥1 minor criteria was most predictive of developing poor outcomes (AUC 0.53, C-statistic 0.60).

• Major criteria included primary tumor diameter ≥40mm, invasion depth beyond subcutaneous fat, poor differentiation, and large caliber perineural invasion (PNI), and minor criteria were invasion depth in subcutaneous fat, moderate differentiation, small caliber PNI and lymphovascular invasion.

• A sensitivity, specificity, and positive and negative predictive values of 7.7%, 97.4%, 33.3% and 86.1%, respectively, were demonstrated by the model.

• In these tumors, 5-year cumulative incidence of poor outcomes was 8.0%, vs 2.8% in other T2a tumors (SHR 3.0).