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

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.