Rong Huang ¹ Jiayu Wang ² Kelin Zheng ² Mengke Zhao ² Zhengyun Zou ^2*

• ¹ Nanjing University, Nanjing, China
• ² Nanjing Drum Tower Hospital, Nanjing, China

Objectives: This study aimed to investigate the impact of socioeconomic status on survival in Chinese patients with acral melanoma. Methods: We collected clinical and socioeconomic information of 298 primary acral melanoma patients, and performed Kaplan–Meier curves, Log‐rank tests, Cox proportional hazards models and Pearson’s chi-squared tests to evaluate the relationships between clinical characteristics, socioeconomic factors, and survival outcomes. Results: Among the clinical characteristics, age, gender, stage, Breslow thickness and primary tumor site significantly impacted survival in acral melanoma patients (p = 0.01, p = 0.05, p < 0.01, p < 0.01, p < 0.01, respectively). Compared to individual socioeconomic factors such as education, occupation, medical insurance, and marital status, the socioeconomic level derived from these four dimensions played a more accurate role in predicting patient survival. Patients with higher socioeconomic status demonstrated significantly reduced mortality risk (HR = 0.60, 95% CI = 0.40-0.91, p = 0.02). However, socioeconomic level was not found to be independent prognostic factor in acral melanoma patients after multivariable adjustment. Notably, a negative correlation was observed between socioeconomic level and Breslow thickness. Conclusions: The socioeconomic level is associated with survival in Chinese acral melanoma patients. However, socioeconomic status per se is not responsible for this association, which might be attributed to Breslow thickness.