Sustained improvement in survival for primary ocular adnexal lymphoma from 2005 to 2024 by model-based period analysis

PURPOSE: Primary ocular adnexal lymphoma (POAL) is the most common malignancy affecting para-ocular tissues, making prognosis and survival critical concerns. This study analyzed trends in five-year relative survival rates (RSR) to evaluate survival outcomes. METHODS: This retrospective study included patients diagnosed with POAL from the Surveillance, Epidemiology, and End Results database. Five-year RSR was calculated for the periods 2005-2009, 2010-2014, and 2015-2019. Data were stratified by demographic and clinical characteristics. Model-based period analysis was conducted to assess RSR trends and project RSR for 2020-2024. RESULTS: The five-year RSR for POAL patients increased from 96.1% to 99.1% between 2005 and 2019, with projections suggesting continued favorable trends. RSR decreased with advancing age but improved across all age groups; for 2020-2024, RSR was projected to approach 100% for patients aged < 50 and 50-69 years, and 98.3% for those ≥ 70 years. Females consistently showed slightly higher RSR than males. White patients demonstrated steady improvement, while Black patients exhibited a fluctuating trend and other racial groups showed modest increases. Higher RSR was observed in patients with conjunctival involvement, unilateral disease, and mucosal-associated lymphoid tissue (MALT) or follicular lymphoma subtypes. CONCLUSION: Survival for POAL patients improved between 2005 and 2019. Projected estimates for 2020-2024, while subject to inherent uncertainty, suggest continued favorable outcomes, providing useful prognostic information for clinicians and patients.