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

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.