Background/aim: Melanoma, an aggressive skin cancer, poses a significant threat to patients' lives, with lower limbs and hips being among the most affected regions. Epidemiology and survival outcomes of patients with melanoma in the lower extremities were investigated and compared to other sites to better understand tumoral behavior and identify predictors of decreased survival.

Patients and methods: The Surveillance, Epidemiology, and End Results (SEER) database was used to search for all skin melanoma cases between 2000 and 2019. Demographic, pathological, and therapeutic factors were compared between affected regions. Overall and disease specific survival were calculated and compared among subgroups. A multivariable analysis was conducted to identify independent prognostic factors.

Results: A total of 50,109 patients were diagnosed with melanoma in lower limbs and hips, while 224,121 patients had melanomas in other areas. More women (70.8%) and younger people (mean 55.2 years, SD 16.5) were affected with lower extremities melanoma, with better survival rates than other skin regions. Factors associated with better survival included female sex, younger age, horizontal growth pattern melanomas, and surgery with <1 cm margins.

Conclusion: Melanoma affecting lower extremities is commonly diagnosed in young females. Prognosis depends on age, stage at diagnosis, and histologic subtype, but remains better compared to other locations.