Epidemiology and Mortality Risk Factors of Sebaceous Carcinoma: A SEER – Based Population Study

Background: Sebaceous carcinoma is a rare and potentially aggressive cutaneous malignancy. It is derived from the adnexal epithelium of sebaceous glands and tends to hold a diverse clinical presentation. Although it is often reported in the periocular region, it can manifest from any sebaceous unit in the skin. Due to the rarity of this condition, prognostic and demographic factors are largely indeterminate. Hence, we sought to assess the prognostic impact of demographic and socioeconomic factors on the outcome of patients with sebaceous carcinoma.   Methods: A retrospective analysis was performed utilizing data from the Surveillance, Epidemiology, and End Results (SEER) database. From the registries, cases of sebaceous carcinoma from the years 2000 to 2018 were analyzed. Univariate and multivariate cox regression analyses were used to analyze the significance of socioeconomic and demographic factors on the survival of sebaceous carcinoma. Tumor grade and extent were included in the multivariate cox regression to minimize confounding.   Results: A total of 4154 cases of sebaceous carcinoma were analyzed within this study. Socioeconomic and demographic factors analyzed includes age, sex, race, and income. On multivariate analysis including tumor grade, tumor extent, age, sex, race and income, African American race was a significant risk indicator for survival (hazard ratio [HR], 1.9; P=.007). Increased age of 70+ were also identified as a significant risk indicator for survival (HR, 5.86; P<0.001). Female sex was identified as a protective indicator for survival (HR, 0.82; P=0.03). Income status did not significantly influence the survival outcome of sebaceous carcinoma.   Conclusion: Although income status did not show any significant influence on the survival outcome of sebaceous carcinoma, sex, race, and age characteristics did. The etiology behind these prognostic factors is unclear but may be related to access to medical care or lack of social support.