The variant of cutaneous squamous cell carcinoma, known as high-risk cutaneous squamous cell carcinoma, has a higher incidence of metastasis. Certain characteristics define this high-risk tumor and are predictors of increased risk of metastasis, although the risk factors are not yet well established. This observational retrospective study of 392 cases of high-risk cutaneous squamous cell carcinoma of the head and neck explored the tumor risk factors for metastasis and the association between metastasis and death. The only factor with a significant positive association with mortality was tumor invasion of noncutaneous structures. A total of 6.6% of the tumors metastasized, and mortality was 30.8%. These findings are consistent with observations reported in the literature.
