title: Uveal metastasis from lung cancer: clinical features, treatment, and outcome in 194 patients.
abstract: OBJECTIVE
  To evaluate the clinical features, treatment, and prognosis of patients with uveal metastasis from lung cancer.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  There were 194 patients with a diagnosis of uveal metastasis from lung cancer.
  
  
  METHODS
  Radiotherapy, chemotherapy, enucleation, or observation.
  
  
  METHODS
  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.
authors.affiliation: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Sanket U
authors.initials: SU
authors.lastname: Shah
authors.affiliation: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania. Electronic address: arman_mash@yahoo.com.
authors.forename: Arman
authors.initials: A
authors.lastname: Mashayekhi
authors.affiliation: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Carol L
authors.initials: CL
authors.lastname: Shields
authors.affiliation: Emory Eye Center, Emory University, Atlanta, Georgia.
authors.forename: Harpreet S
authors.initials: HS
authors.lastname: Walia
authors.affiliation: Emory Eye Center, Emory University, Atlanta, Georgia.
authors.forename: G Baker
authors.initials: GB
authors.lastname: Hubbard
authors.affiliation: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Junjun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Shields
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001918:Brachytherapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D018288:Carcinoma, Small Cell / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D014792:Visual Acuity
chemical_list: D000970:Antineoplastic Agents