Objective:

To identify independent risk factors for postoperative local recurrence in cutaneous squamous cell carcinoma (cSCC) and develop a nomogram for predicting individualized 1-, 2-, and 3-year recurrence probabilities.

Approach:

Key Findings:

• 77 recurrence events were observed during follow-up.
• Independent predictors of recurrence identified were age, tumor size, tumor thickness, histologic differentiation, regional stage, and AJCC stage.
• The nomogram demonstrated good discrimination with area under the curve values ranging from 0.759 to 0.869.
• Patients were stratified into low-risk, intermediate-risk, and high-risk groups based on the nomogram score, with significant differences in recurrence-free survival among groups (log-rank p < 0.0001).

Interpretation:

The nomogram provides a practical tool for individualized prognostic assessment of cSCC recurrence risk.

Limitations:

• The study is retrospective and may be subject to selection bias, potentially affecting the generalizability of the findings.
• The findings may not be generalizable beyond the Asian population studied.

Conclusion:

The developed nomogram may assist in individualized postoperative risk stratification and support personalized follow-up management for cSCC patients.

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