Abstract
High-risk cutaneous squamous cell carcinomas have multiple adverse clinical and pathological features associated with increased risks of recurrence, metastasis, and death. Evaluation includes a thorough clinical and lymph node exam, proper identification of high-risk features, and appropriate imaging studies to evaluate the extent of spread. Multidisciplinary management focuses on local control with aggressive and complete surgical resection, with adjuvant radiation mostly reserved for tumors with perineural invasion, multiple high-risk features, or nodal disease. Chemotherapy options for distant and recurrent disease remain limited and understudied.
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