• 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.