{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T14:01:21Z","timestamp":1780408881190,"version":"3.54.1"},"reference-count":50,"publisher":"Elsevier BV","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T00:00:00Z","timestamp":1772841600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["clinicalkey.es","elsevier.es","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Actas Dermo-Sifiliogr\u00e1ficas"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.ad.2026.104611","type":"journal-article","created":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T16:18:02Z","timestamp":1773418682000},"page":"104611","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of Cutaneous Squamous Cell Carcinoma: Review Based on Guidelines. Part 1: Diagnosis, Staging, and Clinical Management"],"prefix":"10.1016","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6779-6459","authenticated-orcid":false,"given":"S.","family":"Paradela-de la Morena","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Neri-Morales","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Mart\u00edn-Loureiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Tejera-Vaquerizo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E.","family":"Fonseca-Capdevila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ad.2026.104611_bib0255","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/jdv.17531","article-title":"Overview of guideline recommendations for the management of high-risk and advanced cutaneous squamous cell carcinoma","volume":"36","author":"Dessinioti","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.1016\/j.ad.2026.104611_bib0260","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.piel.2017.09.004","article-title":"Incidencia y mortalidad del c\u00e1ncer de piel en Espa\u00f1a","volume":"33","author":"Tejera-Vaquerizo","year":"2018","journal-title":"Piel"},{"key":"10.1016\/j.ad.2026.104611_bib0265","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1001\/jamadermatol.2013.2139","article-title":"Factors predictive of recurrence and death from cutaneous squamous cell carcinoma: a 10-year, single-institution cohort study","volume":"149","author":"Schmults","year":"2013","journal-title":"JAMA Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0270","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1200\/JCO.2012.48.5326","article-title":"Evaluation of American Joint Committee on Cancer, International Union Against Cancer, and Brigham and Women's Hospital Tumor Staging for cutaneous squamous cell carcinoma","volume":"32","author":"Karia","year":"2014","journal-title":"J Clin Oncol"},{"key":"10.1016\/j.ad.2026.104611_bib0275","doi-asserted-by":"crossref","DOI":"10.1016\/j.ad.2024.03.018","article-title":"Estudio longitudinal de los diferentes patrones de progresi\u00f3n en el carcinoma cut\u00e1neo de c\u00e9lulas escamosas de alto riesgo","author":"Tejera-Vaquerizo","year":"2024","journal-title":"Actas Dermo-Sifiliogr"},{"key":"10.1016\/j.ad.2026.104611_bib0280","unstructured":"OCEBM Levels of Evidence. https:\/\/www.cebm.ox.ac.uk\/resources\/levels-of-evidence\/ocebm-levels-of-evidence."},{"key":"10.1016\/j.ad.2026.104611_bib0285","doi-asserted-by":"crossref","first-page":"377","DOI":"10.3390\/cancers14020377","article-title":"The multidisciplinary management of cutaneous squamous cell carcinoma: a comprehensive review and clinical recommendations by a panel of experts","volume":"14","author":"Stanganelli","year":"2022","journal-title":"Cancers"},{"key":"10.1016\/j.ad.2026.104611_bib0290","doi-asserted-by":"crossref","first-page":"629","DOI":"10.3390\/cancers14030629","article-title":"Update on management recommendations for advanced cutaneous squamous cell carcinoma","volume":"14","author":"Garc\u00eda-Foncillas","year":"2022","journal-title":"Cancers"},{"key":"10.1016\/j.ad.2026.104611_bib0295","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/bjd.19621","article-title":"British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma 2020","volume":"184","author":"Keohane","year":"2021","journal-title":"Br J Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0300","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1016\/j.jaad.2017.10.007","article-title":"Guidelines of care for the management of cutaneous squamous cell carcinoma","volume":"78","author":"Kim","year":"2018","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0305","article-title":"European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma. Part 1: Diagnostics and prevention \u2013 update 2023","volume":"193","author":"Stratigos","year":"2023","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.ad.2026.104611_bib0310","article-title":"European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma: Part 2. Treatment \u2013 update 2023","volume":"193","author":"Stratigos","year":"2023","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.ad.2026.104611_bib0315","doi-asserted-by":"crossref","first-page":"e288","DOI":"10.1111\/1346-8138.15889","article-title":"Japanese dermatological association guidelines: outlines of guidelines for cutaneous squamous cell carcinoma 2020","volume":"48","author":"Ansai","year":"2021","journal-title":"J Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0320","article-title":"Clinical Practice","year":"2019","journal-title":"Guidelines for Keratinoyte Cancer"},{"key":"10.1016\/j.ad.2026.104611_bib0325","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s00105-020-04620-4","article-title":"Kutanes plattenepithelkarzinom","volume":"71","author":"Leiter","year":"2020","journal-title":"Hautarzt"},{"key":"10.1016\/j.ad.2026.104611_bib0330","first-page":"400","article-title":"S3 guideline for actinic keratosis and cutaneous squamous cell carcinoma (cSCC) \u2013 short version, Part 2: Epidemiology, surgical and systemic treatment of cSCC, follow-up, prevention and occupational disease","volume":"18","author":"Leiter","year":"2020","journal-title":"J Dtsch Dermatol Ges"},{"key":"10.1016\/j.ad.2026.104611_bib0335","doi-asserted-by":"crossref","first-page":"100004","DOI":"10.1016\/j.ejcskn.2023.100004","article-title":"German S3 guideline \u201cactinic keratosis and cutaneous squamous cell carcinoma\u201d \u2013 long version of the update 2023","volume":"1","author":"Leiter","year":"2023","journal-title":"EJC Skin Cancer"},{"key":"10.1016\/j.ad.2026.104611_bib0340","series-title":"Squamous Cell Skin Cancer (Version 2. 2025) [Internet]. NCCN Clinical Practice Guidelines in Oncology","author":"Bordeaux","year":"2025"},{"key":"10.1016\/j.ad.2026.104611_bib0345","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1111\/jdv.15846","article-title":"Comparison of guidelines for the management of patients with high-risk and advanced cutaneous squamous cell carcinoma \u2013 a systematic review","volume":"33","author":"Heppt","year":"2019","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.1016\/j.ad.2026.104611_bib0350","series-title":"AJCC Cancer Staging Manual","first-page":"171","article-title":"Cutaneous squamous cell carcinoma of the head and neck","author":"Califano","year":"2017"},{"key":"10.1016\/j.ad.2026.104611_bib0355","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.det.2019.03.009","article-title":"Cutaneous squamous cell carcinoma","volume":"37","author":"Bander","year":"2019","journal-title":"Dermatol Clin"},{"key":"10.1016\/j.ad.2026.104611_bib0360","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.jaad.2023.02.048","article-title":"Prognostic factors for satellitosis or in-transit metastasis in cutaneous squamous cell carcinoma: a multicentric cohort study","volume":"89","author":"Marti-Marti","year":"2023","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0365","doi-asserted-by":"crossref","first-page":"402","DOI":"10.1001\/jamadermatol.2013.2456","article-title":"Evaluation of AJCC tumor staging for cutaneous squamous cell carcinoma and a proposed alternative tumor staging system","volume":"149","author":"Jambusaria-Pahlajani","year":"2013","journal-title":"JAMA Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0370","series-title":"TNM Classification of Malignant Tumours","first-page":"131","article-title":"Skin tumours","author":"Brierley","year":"2017"},{"key":"10.1016\/j.ad.2026.104611_bib0375","first-page":"579","article-title":"Comparison and evaluation of the current staging of cutaneous carcinomas","volume":"10","author":"Breuninger","year":"2012","journal-title":"J Dtsch Dermatol Ges"},{"key":"10.1016\/j.ad.2026.104611_bib0380","doi-asserted-by":"crossref","first-page":"2309","DOI":"10.1016\/j.jid.2017.06.025","article-title":"Survival of patients with cutaneous squamous cell carcinoma: results of a prospective cohort study","volume":"137","author":"Eigentler","year":"2017","journal-title":"J Invest Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0385","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.jaad.2018.06.060","article-title":"Comparing the eighth and the seventh editions of the American Joint Committee on Cancer staging system and the Brigham and Women's Hospital alternative staging system for cutaneous squamous cell carcinoma: Implications for clinical practice","volume":"80","author":"Ca\u00f1ueto","year":"2019","journal-title":"J Am Acad Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0390","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1097\/SAP.0000000000000110","article-title":"The effect of differentiation grade of cutaneous squamous cell carcinoma on excision margins, local recurrence, metastasis, and patient survival: a retrospective follow-up study","volume":"75","author":"Brinkman","year":"2015","journal-title":"Ann Plast Surg"},{"key":"10.1016\/j.ad.2026.104611_bib0395","series-title":"StatPearls","article-title":"Squamous cell skin cancer","author":"Howell","year":"2024"},{"key":"10.1016\/j.ad.2026.104611_bib0400","first-page":"915e9","article-title":"Desmoplastic squamous cell carcinoma of skin and vermilion surface: a highly malignant subtype of skin cancer","author":"Breuninger","year":"1997","journal-title":"Cancer"},{"key":"10.1016\/j.ad.2026.104611_bib0405","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1093\/ced\/llae155","article-title":"Tumour budding as a risk factor for lymph node metastases in cutaneous squamous cell carcinoma: a systematic review and meta-analysis","volume":"49","author":"Gil-Pallares","year":"2024","journal-title":"Clin Exp Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0410","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1111\/ced.13570","article-title":"Rapid growth rate is associated with poor prognosis in cutaneous squamous cell carcinoma","volume":"43","author":"Ca\u00f1ueto","year":"2018","journal-title":"Clin Exp Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0415","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/S1470-2045(08)70178-5","article-title":"Analysis of risk factors determining prognosis of cutaneous squamous-cell carcinoma: a prospective study","volume":"9","author":"Brantsch","year":"2008","journal-title":"Lancet Oncol"},{"key":"10.1016\/j.ad.2026.104611_bib0420","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1001\/jamadermatol.2015.4994","article-title":"Risk factors for cutaneous squamous cell carcinoma recurrence, metastasis, and disease-specific death: a systematic review and meta-analysis","volume":"152","author":"Thompson","year":"2016","journal-title":"JAMA Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0425","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1001\/jamadermatol.2022.5508","article-title":"Association of patient risk factors, tumor characteristics, and treatment modality with poor outcomes in primary cutaneous squamous cell carcinoma: a systematic review and meta-analysis","volume":"159","author":"Zakhem","year":"2023","journal-title":"JAMA Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0430","article-title":"Assessment of the diagnostic accuracy of baseline clinical examination and ultrasonographic imaging for the detection of lymph node metastasis in patients with high-risk cutaneous squamous cell carcinoma of the head and neck","author":"Toker","year":"2021","journal-title":"JAMA Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0435","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1016\/j.ad.2018.10.006","article-title":"Invasi\u00f3n perineural en el carcinoma epidermoide cut\u00e1neo","volume":"110","author":"P\u00e9rez Garc\u00eda","year":"2019","journal-title":"Actas Dermo-Sifiliogr"},{"key":"10.1016\/j.ad.2026.104611_bib0440","doi-asserted-by":"crossref","first-page":"747","DOI":"10.23736\/S0392-0488.18.06093-5","article-title":"Cutaneous squamous cell carcinoma. Italian Guidelines by SIDeMaST adapted to and updating EADO\/EDF\/EORTC guidelines","volume":"153","author":"Peris","year":"2018","journal-title":"G Ital Dermatol Venereol."},{"key":"10.1016\/j.ad.2026.104611_bib0445","doi-asserted-by":"crossref","first-page":"236","DOI":"10.1186\/1471-2407-12-236","article-title":"Detection of cervical lymph node metastasis in head and neck cancer patients with clinically N0 neck\u2014a meta-analysis comparing different imaging modalities","volume":"12","author":"Liao","year":"2012","journal-title":"BMC Cancer"},{"key":"10.1016\/j.ad.2026.104611_bib0450","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1001\/jamadermatol.2013.6675","article-title":"Staging for cutaneous squamous cell carcinoma as a predictor of sentinel lymph node biopsy results: meta-analysis of American Joint Committee on cancer criteria and a proposed alternative system","volume":"150","author":"Schmitt","year":"2014","journal-title":"JAMA Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0455","doi-asserted-by":"crossref","first-page":"671","DOI":"10.2340\/00015555-2942","article-title":"Sentinel lymph node biopsy in cutaneous squamous cell carcinoma series of 37 cases and systematic review of the literature","volume":"98","author":"Lhote","year":"2018","journal-title":"Acta Derm Venereol"},{"key":"10.1016\/j.ad.2026.104611_bib0460","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/1346-8138.14342","article-title":"Systematic review of the prevalence of nodal metastases and the prognostic utility of sentinel lymph node biopsy in cutaneous squamous cell carcinoma","volume":"45","author":"Tejera-Vaquerizo","year":"2018","journal-title":"J Dermatol"},{"key":"10.1016\/j.ad.2026.104611_bib0465","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1002\/lary.27881","article-title":"Sentinel lymph node biopsy for high-risk cutaneous squamous cell carcinoma of the head and neck","volume":"130","author":"Wu","year":"2020","journal-title":"Laryngoscope"},{"key":"10.1016\/j.ad.2026.104611_bib0470","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1177\/1203475415582318","article-title":"Non-melanoma skin cancer in Canada chapter 5: management of squamous cell carcinoma","volume":"19","author":"Sapijaszko","year":"2015","journal-title":"J Cutan Med Surg"},{"key":"10.1016\/j.ad.2026.104611_bib0475","doi-asserted-by":"crossref","first-page":"1588","DOI":"10.1111\/jdv.20051","article-title":"Sentinel lymph node biopsy versus observation in high-risk cutaneous squamous cell carcinoma in immunosuppressed and immunocompetent patients: an inverse probability of treatment weighting study","volume":"38","author":"Tejera-Vaquerizo","year":"2024","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"10.1016\/j.ad.2026.104611_bib0480","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1016\/j.ad.2019.06.005","article-title":"Revisi\u00f3n de los t\u00e9rminos que definen un carcinoma epidermoide cut\u00e1neo asociado a mal pron\u00f3stico","volume":"111","author":"Ca\u00f1ueto","year":"2020","journal-title":"Actas Dermo-Sifiliogr\u00e1ficas"},{"key":"10.1016\/j.ad.2026.104611_bib0485","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.ejca.2018.01.075","article-title":"Advanced cutaneous squamous cell carcinoma: a retrospective analysis of patient profiles and treatment patterns\u2014results of a non-interventional study of the DeCOG","volume":"96","author":"Hillen","year":"2018","journal-title":"Eur J Cancer"},{"key":"10.1016\/j.ad.2026.104611_bib0490","doi-asserted-by":"crossref","DOI":"10.1016\/j.xjidi.2021.100045","article-title":"Evidence-based consensus recommendations for the evolving treatment of patients with high-risk and advanced cutaneous squamous cell carcinoma","volume":"1","author":"Rabinowits","year":"2021","journal-title":"JID Innov"},{"key":"10.1016\/j.ad.2026.104611_bib0495","series-title":"NCCN Guidelines Index Table of Contents Discussion","author":"Schmults","year":"2023"},{"key":"10.1016\/j.ad.2026.104611_bib0500","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1016\/j.ad.2018.03.007","article-title":"Utilidad de la radioterapia en adyuvancia en el carcinoma epidermoide cut\u00e1neo","volume":"109","author":"Ca\u00f1ueto","year":"2018","journal-title":"Actas Dermo-Sifiliogr"}],"container-title":["Actas Dermo-Sifiliogr\u00e1ficas"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0001731026000219?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0001731026000219?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T13:02:48Z","timestamp":1780405368000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0001731026000219"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":50,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["S0001731026000219"],"URL":"https:\/\/doi.org\/10.1016\/j.ad.2026.104611","relation":{},"ISSN":["0001-7310"],"issn-type":[{"value":"0001-7310","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Management of Cutaneous Squamous Cell Carcinoma: Review Based on Guidelines. Part 1: Diagnosis, Staging, and Clinical Management","name":"articletitle","label":"Article Title"},{"value":"Actas Dermo-Sifiliogr\u00e1ficas","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ad.2026.104611","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 AEDV. Published by Elsevier Espa\u00f1a, S.L.U.","name":"copyright","label":"Copyright"}],"article-number":"104611"}}