Uveal metastasis: clinical characteristics, treatment, and prognostic factors in a cohort of 161 patients in China

Haowen Li; Jingting Luo; Zhaoxun Feng; David Maberley; Yang Li; Wenbin Wei; Yueming Liu

doi:10.1016/j.jcjo.2024.12.002

Uveal metastasis: clinical characteristics, treatment, and prognostic factors in a cohort of 161 patients in China

Can J Ophthalmol. 2025 Jan 3:S0008-4182(24)00370-3. doi: 10.1016/j.jcjo.2024.12.002. Online ahead of print.

Authors

Haowen Li¹, Jingting Luo¹, Zhaoxun Feng², David Maberley², Yang Li¹, Wenbin Wei³, Yueming Liu¹

Affiliations

¹ Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology &Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
² Department of Ophthalmology, University of Ottawa, Ottawa, Canada.
³ Beijing Tongren Eye Center, Beijing Key Laboratory of Intraocular Tumor Diagnosis and Treatment, Beijing Ophthalmology &Visual Sciences Key Lab, Medical Artificial Intelligence Research and Verification Key Laboratory of the Ministry of Industry and Information Technology, Beijing Tongren Hospital, Capital Medical University, Beijing, China. Electronic address: [email protected].

PMID: 39761942
DOI: 10.1016/j.jcjo.2024.12.002

Abstract

Objective: To investigate the clinical and prognostic features of uveal metastasis in a Chinese population and compare these features across different primary cancers.

Design: Retrospective cross-sectional study.

Participants: 161 patients with uveal metastasis at Beijing Tongren Hospital.

Methods: Clinical characteristics of the primary tumour and uveal metastasis, treatments and outcomes were reviewed. Tumor regression was assessed using B-scan ultrasonography to measure changes in tumor height.

Results: Among 161 patients, 185 eyes had uveal metastasis. Lung cancer was the most common primary tumour (49.4%), followed by breast cancer (22.4%), kidney cancer (4.3%). Uveal metastasis was the initial cancer manifestation in 39 patients (24.2%). Unilateral involvement was predominant (86.3%), with the choroid being the most common site (91%). Compared with lung cancer and other cancers, breast carcinoma patients developed uveal metastasis at a younger age (p < 0.001), had a longer interval to uveal metastasis diagnosis (0.67, 4.19, and 6.27 years, p < 0.0001), were prone to be bilateral (11.1%, 9.1%, and 27.8%; p < 0.05) and exhibited lower tumour height (4.47 ± 2.49 mm and 4.88 ± 3.01 mm, 3.09 ± 2.46 mm; p < 0.01). Local treatments (133 eyes) included plaque radiotherapy (PRT, brachytherapy), transpupillary thermotherapy (TTT), anti-VEGF and enucleation. The tumour regression correlated with increased tumor height (r = 0.5699; p < 0.05) in eyes treated with PRT (n = 15). Despite effective local tumour control, the 1-year, 3-year, and 5-year survival rates were 72.61%, 31.82%, and 19.84%, respectively (n = 103). Twenty seven of 54 patients died (50%) or died within 1 year of uveal metastasis. The mean survival was 18.84 months. Extraocular metastasis correlated with shorter survival (p < 0.05).

Conclusion: This study provides a comprehensive analysis of uveal metastasis in Chinese patients, highlighting the distinct characteristics from various primaries. Although survival rates remain uncertain, local therapies were effective at achieving ocular tumor control, which aligns with the expectations for patients battling metastatic cancers.