Mortality of uveal melanoma in children and adolescents from 2004 to 2020.

Publication date: Jun 01, 2025

To analyze epidemiological factors, tumor characteristics, and mortality rates in a cohort of pediatric patients with uveal melanoma (UM) from the National Cancer Database (NCDB). In this retrospective cohort study, patients ≤20 years of age in the NCDB diagnosed with UM were included. Patients were identified using ICD-10 and ICD-O-3 codes. Main outcome measures were demographics, clinical features, and overall survival. Mortality was assessed using Kaplan-Meier survival analysis and Cox logistic regression. Significance was defined as P < 0. 05. Of 129 patients (68 females) included, mean age at diagnosis was 15. 9 years. Most patients were White (91. 5%), followed by Black (3. 1%), and other races (5. 4%). Tumors were primarily in the choroid (75. 2%), followed by ciliary body (13. 2%) or iris (7. 0%). Kaplan Meier overall survival at 5-,10-, and 15-years was 93. 6%, 80. 3%, and 63. 4%, respectively. Survival was worse with more advanced tumor T category (10-year survival 73. 8% for cT1, 82. 6% for cT2, 0% for cT4 [P = 0. 022]) and American Joint Committee on Cancer stage (15-year survival 61. 9% for stage I vs 45. 5% for stage III [P < 0. 001]). Cox logistic regression analysis identified older age at presentation (OR = 1. 618, P = 0. 036) and non-White race (OR = 21. 39, P = 0. 045) as significant predictors of mortality. In our study cohort, older age, non-White race, and advanced tumor stage at diagnosis were associated with increased mortality in children and adolescents with UM. Adolescents have a similar prognosis to adults, whereas children have more favorable outcomes.

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