背景：下肢和髋部皮肤默克尔细胞癌是一种罕见的皮肤肿瘤，复发率高。
目的：评估下肢和髋部默克尔细胞癌的流行病学和生存结果，在文献中很少提到。
方法：监测，流行病学,并检索了2000年至2018年间所有皮肤默克尔细胞癌病例的最终结果数据库。使用t检验或χ2检验比较下肢和其他皮肤定位之间的人口统计学和临床病理特征。使用Kaplan-Meier方法计算下肢Merkel细胞癌的总生存期(OS)。使用对数秩检验比较亚组。多因素cox回归用于确定独立的预后因素。
结果：总计，确定了976名患者。平均年龄为72.7岁。中位OS为68个月,比其他本地化更好。年纪大了,区域淋巴结，远处转移与低OS相关。手术边缘>1厘米，当与放疗相关时，有最好的操作系统。年龄,肿瘤大小,淋巴结状态，转移的存在，和治疗顺序被确定为独立的预后因素。
结论：下肢和髋部Merkel细胞癌的OS优于其他皮肤定位肿瘤。在这个数据集中，采用>1cm切缘手术和辅助放疗确保最佳OS.
BACKGROUND: Merkel cell carcinoma of lower limb and hip skin is a rare skin tumor that has a high recurrence rate.
OBJECTIVE: To assess epidemiology and survival outcomes of the lower limb and hip Merkel cell carcinoma, which are less addressed in the literature.
METHODS: The Surveillance, Epidemiology, and End Results database was searched for all cases of skin Merkel cell carcinoma between 2000 and 2018. Demographic and clinicopathologic features were compared between lower limb and other skin localizations using the t test or χ2 test. The overall survival (OS) of lower limb Merkel cell carcinoma was calculated using the Kaplan-Meier method. Subgroups were compared using the log rank test. Multivariate cox regression was used to identify independent prognostic factors.
RESULTS: In total, 976 patients were identified. The mean age was 72.7 years. The median OS was 68 months, better than that of other localizations. Older age, regional lymph node, and distant metastasis were associated with low OS. Surgery with >1-cm margins, when associated with radiotherapy, had the best OS. Age, tumor size, lymph node status, presence of metastasis, and treatment sequence were identified as independent prognostic factors.
CONCLUSIONS: Lower limb and hip Merkel cell carcinomas have better OS than tumors in other skin localizations. In this dataset, the best OS was ensured using surgery with >1-cm margins and adjuvant radiotherapy.
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