riSCC: A personalized risk model for the development of poor outcomes in cutaneous squamous cell carcinoma
Published in Journal of the American Academy of Dermatology, 2025
Recommended citation: Jambusaria-Pahlajani, A.*, Jeanselme, V.*, Wang, D., Ran, N., Granger, E., Cañueto, J., Brodland, D., Carr, D., Carter, J., Carucci, J., Hirotsu, K., Karn, E., Koyfman, S., Mangold, A., Girardi, F., Shahwan, K., Srivastava, D., Vidimos, A., Willenbrink, T., Wysong, A., Lotter, W., Ruiz, E. (2025). riSCC: A personalized risk model for the development of poor outcomes in cutaneous squamous cell carcinoma. In Journal of the American Academy of Dermatology. https://www.jaad.org/article/S0190-9622(25)00373-1/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 (BWH) and American Joint Committee on Cancer Staging 8th Edition (AJCC8) 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 23,166 localized CSCC tumors were included. riSCC prognostic model performed superiorly to American Joint Committee on Cancer 8th edition and Brigham and Women’s Hospital T staging for all outcomes. At five years, the C-index for riSCC ranged from 0.74 for LR to 0.87 for DSD.
Limitations Retrospective study design
Conclusions riSCC prognostic model offers fine-grained risk estimates and improved stratification for important CSCC outcomes compared to T staging systems.