title: Management and Outcome of Uveal Melanoma in a Single Tertiary Cancer Center in Jordan.
abstract: OBJECTIVE
  The aim of this study was evaluate the features and outcome of management of uveal melanoma in King Hussein Cancer Center as an example of a referral tertiary cancer center in the Middle East.
  
  
  METHODS
  This was aetrospective, observational case series of 46 eyes of 46 patients with uveal melanoma. Data collection required access to medical records, radiology and pathology reports, and laboratory results. The main outcome measures included age at diagnosis, tumor location and dimensions, TNM stage, treatment modality, visual outcome, metastasis, and mortality.
  
  
  RESULTS
  There was slight female preference, and the median age at diagnosis was 45 years. Eighteen (39%) eyes were treated by primary enucleation, and 28 (61%) eyes were treated by I-125 radioactive plaque. The melanoma was in the choroid in 40 (87%) eyes and in the ciliary body in 6 (13%) eyes, with no single tumor in the iris. According to the 7th edition of the American Joint Committee on Cancer staging system (UICC/AJCC); 8 (17%) were T1, 17 (36%) were T2, 16 (35%) were T3, and 5 (11%) were T4. One (2%) patient showed lymph node metastasis (N1), and 6 (13%) patients showed distant metastasis (M1). Pathologically, 2 (10%) of the enucleated eyes were spindle cell type, 4 (20%) were epithelioid cell type, and 14 (70%) were mixed type. Extrascleral extension was seen in three (15%) eyes, and optic nerve invasion in two (10%) eyes. After brachytherapy, 26 (93%) eyes were salvaged, and 2 eyes were consecutively enucleated; one for tumor recurrence, and one for uncontrolled painful neovascular glaucoma. The eye salvage rate post plaque was 93% (26/28), and the visual acuity for the salvaged eyes was equal or better than 0.5 in 11 (42%) eyes, 0.1-0.4 in 5 (19%) eyes, and less than 0.1 in 10 (38%) eyes.
  
  
  CONCLUSIONS
  The incidence of uveal melanomas in our region is low compared to that in the West with a younger age at presentation. Candidate tumors for radioactive plaque therapy were successfully controlled in 93% of cases.
authors: Departments of Ophthalmology, King Hussein Cancer Centre (KHCC), Amman, Jordan.
authors: Ahmed
authors: A
authors: Zewar
authors: Ibrahim
authors: I
authors: Nawaiseh
authors: Imad
authors: I
authors: Jaradat
authors: Jakub
authors: J
authors: Khzouz
authors: Khaleel
authors: K
authors: Alrawashdeh
authors: Ghadeer
authors: G
authors: Abdeen
authors: Mustafa
authors: M
authors: Mehyar
authors: Samer
authors: S
authors: Khurma
authors: Yacoub A
authors: YA
authors: Yousef
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001918:Brachytherapy; D002648:Child; D002675:Child, Preschool; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D015994:Incidence; D007597:Jordan / Q000453:epidemiology; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D012189:Retrospective Studies; D062606:Tertiary Care Centers; D014604:Uveal Neoplasms / Q000453:epidemiology* / Q000473:pathology* / Q000628:therapy; D055815:Young Adult; D000098943:Uveal Melanoma