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BackgroundInoperable cutaneous squamous cell carcinomas (SCCs) are rare and life-threatening, but few studies have investigated their causal factors. ObjectivesOur aim was to determine factors associated with inoperable SCCs, as well as patient and tumour characteristics, and care pathway-related factors. Materials & MethodsBased on an observational retrospective study at Reims University Hospital, France, the characteristics of tumours and patients were recorded based on 73 cases of inoperable SCCs and compared with 73 cases of operable SCCs. In addition, the clinical history and care pathway associated with inoperable cases was documented. ResultsIn patients with inoperable SCCs, the median overall survival (OS) time was 7.6 months and the three-year OS was <5%. Compared to patients with operable tumours, those with inoperable tumours were older (83 vs 78.9; p = 0.018) and more frequently had a history of senile dementia (21.9% vs 8.2%; p = 0.048), cardiovascular disease (75.3% vs 50.7%; p = 0.009) or a tumour with poor or moderate differentiation (30.9% vs 13.3%; p= 0.04). A long delay between tumour appearance and first consultation with a dermatologist (median: five months), failing to attend further medical or surgical appointments (21%), initial refusal of surgery (18%), reluctance to accept doctors’ recommendations by the family and/or patient (26%), and absence of surgical revision after a previous incomplete excision (29%) were identified as potentially modifiable factors associated with inoperable SCCs. ConclusionThere is a need for better information for both patients and doctors concerning the potential severity of SCCs and the importance of early and appropriate management, specifically in older and frail patients