Trends in Demographic, Clinical, Socioeconomic, and Facility-Specific Factors Linked to Eyelid Melanoma Survival: A National Cancer Database Analysis.

Abstract

Purpose: This study aimed to analyze demographic, clinical, socioeconomic, and facility-specific factors affecting the survival outcomes of patients diagnosed with eyelid melanoma (EM) between 2004 and 2017 using data from the National Cancer Database.

Methods: Cases of EM diagnosed between 2004 and 2017 were identified using the National Cancer Database. Patient demographic data, tumor stage (American Joint Committee on Cancer TNM classification), treatment modalities, and socioeconomic variables were collected. Facility-specific variables included patient volume and academic status. Kaplan-Meier survival analyses and multivariate Cox regression models were used to assess 10-year survival and identify significant predictors of mortality.

Results: A total of 3,235 patients with EM were eligible for demographic analysis. The majority of patients were over 60 years of age and predominantly male. Kaplan-Meier analysis showed a significant decrease in 10-year overall survival with increasing age at diagnosis (p < 0.001), T clinical stage (p < 0.001), and male sex (p = 0.001). Additionally, patients with higher income (p = 0.01), private insurance (p < 0.001), and those treated at high-volume (p = 0.006) and academic facilities (p = 0.005) had improved 10-year overall survival. Multivariate Cox regression identifying independent predictors of EM mortality corroborated these findings.

Conclusions: Eyelid melanoma survival outcomes were significantly influenced by age, tumor stage, socioeconomic status, and facility characteristics. Treatment at high-volume centers confers a survival advantage, emphasizing the importance of specialized care. These findings underscore the need for early detection and equitable access to improve EM outcomes.