Evaluating the Impact of Age and Sex on Survival in Localised Anterior Uveal Melanoma Undergoing Eye-Preserving Interventions Within a Surveillance, Epidemiology, and End Results (SEER) Cohort

TL;DR

This study found that age strongly affects survival in patients with anterior uveal melanoma treated to preserve the eye, while sex does not.

Contribution

The study identifies age as a significant prognostic factor in anterior uveal melanoma, while showing no impact of sex.

Findings

Patients aged 70 or older had over tenfold higher mortality risk compared to those under 50.

Age groups showed significant survival differences, but sex had no effect on survival outcomes.

The 50-69 age group showed a trend toward higher risk, though not statistically significant.

Abstract

Purpose

The purpose of the study was to evaluate the prognostic influence of age and sex on survival in patients with iris and ciliary body melanoma who were treated with eye-preserving interventions.

Methods

A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database. We included patients diagnosed between 2000 and 2017 with localised iris or ciliary body melanoma who underwent local excision or radiotherapy. Kaplan-Meier curves with log-rank testing were used to assess survival differences by age (<50, 50-69, ≥70 years) and sex. We performed multivariable Cox regression to adjust for covariates.

Results

Ninety-nine patients met the inclusion criteria, with a median follow-up of 117 months. Age distribution was <50 years (n=17), 50-69 years (n=58), and ≥70 years (n=24). Overall survival significantly differed by age (log-rank p<0.001). Patients who were 70 years or older had more than a tenfold increased mortality risk compared with those who were younger than 50 (HR 10.65, 95% CI 2.46-46.07, p=0.002). The 50-69 years group demonstrated a trend toward increased risk (HR 3.99, 95% CI 0.94-17.01, p=0.061). In contrast, sex was not associated with survival (HR 1.02, 95% CI 0.54-1.92, p=0.944; log-rank p=0.87).

Conclusions

Age is a strong prognostic factor in localised iris and ciliary body melanoma treated with eye-preserving strategies, whilst sex does not influence survival. These findings underscore the value of demographic risk stratification in clinical management of anterior uveal melanoma.

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