Invasion beyond subcutaneous fat and poor histologic differentiation may carry a greater risk of poor outcomes than other factors in high risk cutaneous squamous cell carcinoma (hrSCC), according to a recent study. However, Mohs surgery alone provides excellent marginal control with low rates of local recurrence, nodal metastasis, and disease-specific death. Researchers conducted a retrospective chart review of all hrSCC patients treated in a clinic from October 2011 to December 2015, and found:

• 647 hrSCC tumors that met inclusion criteria were identified.
• During the follow-up period, there were 19 local recurrences(LR) (2.9%), 31 nodal metastases(NM) (4.8%), 7 distant metastases(DM) (1.1%), and 7 disease-specific deaths(DSD) (1.1%).
• 2 factors—poor differentiation and invasion beyond the subcutaneous fat—were positively associated with local recurrence, nodal metastasis, and disease-specific death through multivariate analysis.