Age outweighs race in survival of sebaceous gland carcinoma of the eyelid: A 21-year SEER database analysis

Purpose

Sebaceous gland carcinomas (SC) are rare neoplasms arising from the eyelids’ sebaceous glands. Investigating racial disparities in their occurrence, management, and outcomes is crucial for enhancing patient care.

Design

Retrospective database analysis.

Methods

Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database, which collects cancer incidence and survival data from diverse geographic regions in the United States, representing approximately 48 % of the U.S. population, for patients diagnosed with SC between 2000 and 2021. Patients were stratified into four racial groups: White, Black, Asian/Pacific Islander, and American Indian/Alaska Native. Incidence rates, stage at diagnosis, treatment modalities, and survival outcomes were analyzed. A multivariate Cox regression model assessed the prognostic impact of age and radiation therapy on survival, adjusting for relevant confounders.

Results

Among 969 patients diagnosed with eyelid SC, 615 were aged 70 years or older, accounting for approximately 63 percent, with a slight female predominance of 55.5 percent. White patients had survival rates of 49.5 % while patients from other racial groups had survival rates of 59.3 %. The Log-Rank test found no statistically significant survival differences by race (P = 0.075). Multivariate analysis identified advanced age (≥70 years) as a strong independent prognostic factor for decreased survival (hazard ratio = 4.50, CI: 2.67–7.59: p < 0.001). Additionally, radiation therapy was significantly associated with an increased risk of mortality (hazard ratio = 1.59, 95 % CI: 1.10–2.29; p = 0.01), highlighting its prognostic significance in the management of SC. While race was not statistically significant, white race exhibited a higher risk (hazard ratio = 1.16, CI: 0.88–1.53; p = 0.28).

Conclusion

Survival outcomes did not significantly differ by race; however, age was identified as a critical prognostic factor. Larger sample sizes are needed to establish additional risk factors and assess potential disparities among underrepresented populations.