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The following is a summary of “Identifying the Impact of Minor Risk Factors in Brigham and Women’s Hospital Stage T1 Cutaneous Squamous Cell Carcinomas on Risk of Poor Outcomes: A Retrospective Cohort Study,” published in the February 2025 issue of Journal of the American Academy of Dermatology by Shahwan et al. 

Despite the generally favorable prognosis of T1 cutaneous squamous cell carcinomas (CSCCs) at Brigham and Women’s Hospital (BWH), a subset of cases exhibits poor outcomes.  

Researchers conducted a retrospective study to investigate the influence of minor risk factors on poor outcomes in T1 tumors.  

They collected data from 11 centers. Univariable and multivariable regression analyses were used to estimate the effect of minor risk factors, including moderate differentiation, tumor diameter of 1 to 2 centimeters, fat invasion, and small-caliber perineural invasion (PNI), on poor outcomes. Cumulative incidence function (CIF) plots were generated to illustrate the time to poor outcomes based on the number of minor risk factors.  

The results showed that 15,481 BWH T1 tumors were analyzed, with 90 (0.58%) developing major poor outcomes and 332 (2.1%) experiencing any poor outcomes. Multivariable analysis identified moderate differentiation, tumor diameter, and subcutaneous fat invasion as significant minor risk factors. The CIF plots indicated a higher risk of poor outcomes with multiple minor risk factors, with the risk of metastasis and major poor outcomes exceeding 5% in tumors presenting with 3 minor risk factors.  

Investigators concluded that T1 tumors with multiple minor risk factors warranted closer surveillance, and future staging systems should integrate both major and minor risk factors. 

Source: jaad.org/article/S0190-9622(25)00345-7/abstract