Analysis of Uveal Melanoma 5-Year Survival Rates by Medicaid Status: A Nationwide Analysis

Abstract

ABSTRACT Purpose The survival outcomes of patients with primary uveal melanomas based on Medicaid status have not been previously discussed in the literature. Methods The Surveillance, Epidemiology, and End Results Medicaid database were utilized to identify patients with primary uveal melanomas diagnosed between 2006 and 2013. The Kaplan–Meier method was utilized to construct 5-year survival curves in adult, non-elderly patients. Log-rank testing was used to determine differences in survival rates, and multivariate Cox proportional hazards modeling was utilized to perform adjusted survival analysis. Results A total of 1,765 patients were included (Medicaid: 81, non-Medicaid: 1684). A total of 1683 (95.4%) were White. The average age was 51.75 years (SD = 9.5 years). Medicaid patients were more likely to be unmarried, live in a high poverty neighborhood, and live in a rural area (all p < .001). We observed no significant difference in 5-year survival rates between those enrolled in Medicaid (86.6%, 95% CI: 79.1%1–94.7%) and those not enrolled in Medicaid (85.5, 95% CI: 83.8%–87.2%) (p = .80). After controlling for socioeconomic and clinical factors, Medicaid enrollment was not associated with an increased risk of mortality compared to non-Medicaid enrollment. Age (aHR: 1.04, 95% CI: 1.02–1.06, p < .001) and tumor size >10 mm (aHR: 3.04, 95% CI: 1.49–6.21, p = .002) were associated with an increased risk of mortality. Conclusion Medicaid enrollment was not associated with worse cancer-specific 5-year survival. Further research needs to be elicited to better understand the role of Medicaid enrollment in patients with primary uveal melanoma.