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The epidemiological data on advanced cSCC are rare due to underreporting or exclusion of cSCC from national cancer registries. Although the frequency of local recurrence has been reported, there is no clear evidence on the incidence or mortality of locally advanced cSCCs, e.g. locally infiltrating or locally recurrent cSCCs that are not further amenable to curative surgery or radiotherapy. This gap of knowledge on the epidemiology of locally advanced cSCC, highlights the need for standardisation in defining and reporting both locally advanced and metastatic cSCC. Even though metastatic cSCCs are a small part of cSCCs (3%\u20135%), their aggressive characteristics contribute to significant morbidity, higher mortality and are those likely to require systemic treatments. Locally recurrent and metastatic cSCC may occur more frequently in high\u2010risk cSCCs (up to 35%). The site of metastasis involves in the vast majority the regional lymph nodes, with the head and neck lymph nodes or parotid most commonly affected. Metastasis occurs mostly within 2\u20133\u2009years of the primary cSCC diagnosis. The knowledge of the incidence and prognosis of advanced cSCC and the risk stratification of patients, who may progress to advanced cSCC, emerge as pressing research areas with important implications for cost\u2010efficiency planning and optimisation of patient care.<\/jats:p>","DOI":"10.1111\/jdv.17709","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T16:04:37Z","timestamp":1633017877000},"page":"39-50","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":46,"title":["Epidemiology of advanced cutaneous squamous cell carcinoma"],"prefix":"10.1111","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4832-3410","authenticated-orcid":false,"given":"C.","family":"Dessinioti","sequence":"first","affiliation":[{"name":"Department of Dermato\u2010Oncology 1st Department of Dermatology Andreas Sygros Hospital University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Pitoulias","sequence":"additional","affiliation":[{"name":"Department of Dermato\u2010Oncology 1st Department of Dermatology Andreas Sygros Hospital University of Athens Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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