Retrospective Registry for Uveal Melanoma in Lebanon: 10-year Single-Center Experience of a Major Referral Center in the Middle East and North Africa

Introduction: Uveal melanoma (UM) is the most common primary intraocular malignancy in adults, comprising 80% of ocular melanomas. Despite advances in tumor control, metastatic potential remains high, with the 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 available on patients with uveal melanoma treated in the past 10 years at the American University of Beirut Medical Center, focusing on factors affecting disease severity, clinical progression, and treatment modalities.

Methods: This study reviews the clinical, molecular, and histopathologic data of these patients. Data was retrieved from electronic health records, including baseline demographics, tumor characteristics, treatment modalities, and disease progression. Patients above 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 mean age at diagnosis of our sample was 49.7 +- 20.13 years, predominantly comprised of male (66.67%), middle eastern (100%) patients aged > 60 (60%). Tumors lacked heterochromia (100%), portrayed melanocytotic (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 mostly in stage 1 (45%), did not involve nearby lymph nodes (60%), and did not have evidence of metastasis at diagnosis (88.89%). In total, 63.63% of our sample underwent surgery initially, with enucleation being the most common (55.56%).

Conclusion: UM remains a challenging malignancy with high metastatic potential if not detected early. This study provides valuable insights into the demographic, clinical, and treatment-related factors affecting UM outcomes in Lebanon. Further studies are needed, however, to better understand the molecular and clinical factors that influence disease progression.