Retrospective registry for uveal melanoma in Lebanon: 10-year single-center experience of a major referral center in the Middle East and North Africa region.

Abstract

e21603 Background: Uveal melanoma (UM) is the most common primary intraocular malignancy in adults, comprising 80% of ocular melanomas. Despite advances in tumor control, survival rates have remained unchanged. The global incidence of UM varies, with scarcity of data available from the MENA region, including Lebanon. UM is biologically distinct from cutaneous melanoma, with GNAQ and GNA11 mutations accounting for over 80% of cases. Metastatic potential is high, with liver, lungs, and bone being the most common sites. Once metastasis occurs, survival drops to 6–12 months. The aim of this study is to summarize the data on patients with UM treated in the past 10 years at the American University of Beirut Medical Center, a major tertiary referral center, focusing on factors influencing disease severity, clinical progression, and treatment modalities. Methods: This retrospective cohort study reviews the clinical, molecular, and histopathologic data of patients with UM treated at AUBMC over the past 10 years. Data was retrieved from electronic health records, including baseline demographics, tumor characteristics, treatment modalities, and disease progression. Patients aged > 18 years with confirmed uveal melanoma were included, while those treated outside AUBMC or lost to follow-up were excluded. Descriptive statistics and regression analysis was conducted to identify factors influencing disease severity and outcomes. Results: The median age at diagnosis of our sample was 51.5 years. Our sample was predominantly comprised of males (66.67%), middle eastern (100%), and aged greater than 60 (60%). Tumors lacked heterochromia (100%), portrayed melanocytosis (75%), and mostly occurred in the choroid macula or choroid macula to the epicenter. The mean thickness at presentation was 7.32 +- 6.33 mm. Tumors were most commonly brown (50%), then yellow (30%), and mixed (20%), and 55% of lesions contained subretinal fluid. Tumors were most commonly in stage 1 (45%), did not involve nearby lymph nodes (60%), and did not have evidence of metastasis at diagnosis (88.89%). 63.63% of our sample underwent surgery initially, with enucleation being the most common (55.56%). None of our cases had recurrence of their disease. In our sample, 75% were still alive at the time of their last follow-up, death from melanoma occurred 16.67% of our sample, and death from other causes occurred in 8.33%. Conclusions: UM remains a challenging malignancy with high metastatic potential if not detected early. This study provides valuable insights into several factors affecting UM in Lebanon, highlighting the increased incidence in males with predominant choroidal involvement. Further studies are needed to better understand the factors influencing disease progression, which will help guide the development of personalized treatment strategies aimed at improving overall prognosis.