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Uveal metastasis from lung cancer: clinical features, treatment, and outcome in 194 patients.

Abstract：

PURPOSE:To evaluate the clinical features, treatment, and prognosis of patients with uveal metastasis from lung cancer. DESIGN:Retrospective chart review. PARTICIPANTS:There were 194 patients with a diagnosis of uveal metastasis from lung cancer. INTERVENTION:Radiotherapy, chemotherapy, enucleation, or observation. MAIN OUTCOME MEASURES:Ocular tumor control, final visual acuity, and tumor-related death. RESULTS:There were 374 uveal metastatic tumors originating from primary lung cancer in 229 eyes of 194 patients. Tumor location included choroid (88%), ciliary body (2%), and iris (10%), with bilateral involvement in 18%. Diagnosis of uveal metastasis preceded the diagnosis of primary lung cancer in 44% of patients. The choroidal metastatic focus had a mean basal diameter of 8 mm and mean thickness of 3 mm, and were mostly located posterior to the equator (91%). The choroidal metastasis commonly had yellow or orange color (98%), had plateau (61%) or dome (38%) configuration, and displayed associated subretinal fluid (85%). Choroidal tumors were multifocal in 49 cases (23%). Ciliary body tumors were commonly dome shaped (75%) with an episcleral sentinel vessel (75%). Iris tumors were multifocal in 2 cases (13%), had visible intrinsic vessels (97%), and were associated with tumor seeding in the angle (38%) or on the iris stroma (25%). The uveal metastases were treated with teletherapy (31%), chemotherapy (18%), brachytherapy (9%), chemotherapy combined with teletherapy or brachytherapy (14%), enucleation (3%), or observation (21%). At last visit, eyes with follow-up showed tumor regression (66%), stability (12%), growth (14%), recurrence (3%), or new metastasis (5%). Visual acuity improved or remained stable in 59% eyes. One-year mortality from the time of detection of uveal metastasis was 54%. CONCLUSIONS:Of 194 patients with uveal metastasis from lung cancer, 44% did not have a history of known lung cancer. Current methods of ocular treatment allow globe salvage in 92% of patients and improved/stable vision in 59% of patients. Systemic prognosis remains poor with tumor-related death in 54% of patients at 1 year.

journal_name

Ophthalmology

journal_title

Ophthalmology

authors

Shah SU,Mashayekhi A,Shields CL,Walia HS,Hubbard GB 3rd,Zhang J,Shields JA

doi

10.1016/j.ophtha.2013.07.014

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

352-357

issue

eissn

0161-6420

issn

1549-4713

pii

S0161-6420(13)00613-1

journal_volume

121

pub_type

杂志文章,多中心研究

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Uveal metastasis from lung cancer: clinical features, treatment, and outcome in 194 patients.