Factors Affecting Survival of Patients With Eyelid Melanoma
By Lynda Seminara
Selected by Richard K. Parrish II, MD
Journal Highlights
American Journal of Ophthalmology, February 2022
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The incidence of cutaneous melanoma has soared globally in recent decades, and the morbidity and mortality rates remain high. Go et al. reviewed data for a large population of patients with this cancer and found several significant predictors of poor outcome: age at diagnosis, lymph node involvement, T4 disease stage, and the nodular histologic subtype.
All patients in the study had a diagnosis of primary melanoma of the eyelid, established between 1975 and 2016 and documented in the Surveillance, Epidemiology and End Results (SEER) database. Detailed data were extracted for each patient, including sex, race, age, tumor depth, cancer stage, histologic grade and subtype, and length of survival. Main outcomes were survival rates (Kaplan-Meier analysis) and mortality hazard ratios (HRs), assessed for overall survival and disease-specific survival.
Altogether, 2,257 patients qualified for the study. Of these, 1,380 had melanoma in situ, and 877 had invasive melanoma. Five years after diagnosis, the overall survival rate was 88.6% for patients with melanoma in situ and 77.1% for those with invasive melanoma. Disease-specific survival rates were 99.4% and 91.0%, respectively. Cox regression analysis of invasive melanoma showed lower survival rates for patients older than 74 years at diagnosis (HR, 2.17; p = .04), with stage T4 disease (HR, 8.45; p < .001), with lymph node involvement (HR, 3.61; p = .03), or with the nodular subtype (HR, 3.31; p = .003). The most common subtype of invasive melanoma was lentigo maligna (20.9%). Unlike findings of previous research, females did not fare better than males. Race and tumor ulceration did not affect the likelihood of survival.
To the authors’ knowledge, this is the largest survival-related study of patients with cutaneous melanoma of the eyelid. They stressed the importance of appropriate prognostic counseling for patients at risk of poor outcomes.
The original article can be found here.