Abstract Purpose: This study aimed to characterize the epidemiology, survival outcomes, and prognostic factors of primary malignant eyelid tumors, specifically sebaceous adenocarcinoma, malignant melanoma, and Merkel cell carcinoma (MCC). Methods: We conducted a retrospective analysis of 3,082 cases of primary eyelid malignancies diagnosed between 2004-2021 from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were categorized by histological subtype, age, race, tumor stage, and treatment modality. Kaplan-Meier survival analysis, log-rank tests, and Cox proportional hazards regression were employed to evaluate survival and identify prognostic factors. Results: Sebaceous adenocarcinoma was the most prevalent subtype (26.57%), followed by malignant melanoma and MCC. Most patients (77.28%) were over 60 years old. While White individuals constituted the majority (86.9%), sebaceous adenocarcinoma showed a higher prevalence in Asian or Pacific Islander populations (11.8%). MCC exhibited the highest rate of distant metastases at diagnosis (19.4%). Surgery was the primary treatment (81.6%). Survival outcomes varied significantly by histology: MCC had the worst prognosis (5-year survival: 43.1%; median: 48 months), whereas melanoma had the best (5-year survival: 71.7%; median: 164 months). Cox regression identified age 60 years (HR: 4.25) and radiation therapy (HR: 2.01) as significant predictors of poor survival. Conclusion: Malignant eyelid tumors exhibit significant heterogeneity in survival. MCC is associated with the highest mortality, and advanced age and radiation therapy are key prognostic factors, underscoring the need for histology-specific management strategies. Citation Format: Bashar I. said yaseen, Almaraziq, Shaimaa A. Abdelmoneim, Ahmad S. Al Sakini, Hamza Khoursheed, Joud K. Alhousani, Alhareth Alhusban, Leen Abu Rabi, Ahmad Farouk Alzein, Issam Khourshid, Mohammad Almajali, Hashem Abu Serhan. Epidemiology, survival, and prognostic factors of malignant eyelid tumors: A 17-year population-based study abstract. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 3574.
Yaseen et al. (Fri,) studied this question.