The Brigham and Women's Hospital (BWH) and the Tübingen cutaneous squamous cell carcinoma (CSCC) stratification systems propose different criteria from the AJCC8. Our group identified prognostic subgroups within T3-AJCC8, the most common classification for high-risk CSCCs (HR-CSCCs).To compare the performance and prognostic accuracy of these staging systems in a subset of HR-CSCCs.Homogeneity, monotonicity and McNemar tests for pair-wise comparisons were assessed. Distinctiveness and relative risk of poor outcome were calculated by stage. Prognostic accuracy was compared with respect to quality (AIC and BIC), concordance (Harrell C-index, Gönen & Heller CPE) and predictive accuracy (sensitivity, specificity, negative predictive value [NPV], positive predictive value [PPV], global accuracy).The BWH and Salamanca systems were more distinctive, homogeneous and monotonic than the Tübingen system. The Tübingen system was the most specific, while the Salamanca and BWH systems were more sensitive. NPV was high in all three systems, but PPV and accuracy were low overall.Alternative staging systems may partially overcome the heterogeneity and low prognostic accuracy of the AJCC8 and enable HR-CSCCs to be stratified more reliably, but their prognostic accuracy is still low. Considering the accumulation of risk factors may improve HR-CSCC risk stratification.