Extraocular extension in melanoma at an Ocular Oncology Unit in Buenos Aires

Purpose: Extrascleral extension (EOE) of uveal melanoma is a known negative prognostic factor, more frequently observed in medium to large tumors. Although EOE is typically limited in size, extensive cases present significant challenges in treatment planning, and the optimal management approach remains controversial.This study aims to estimate the incidence of EOE in patients with uveal melanoma and analyze the prognosis of patients treated at the Italian Hospital of Buenos Aires from 2007 to June 2024. Methods: We conducted an observational, analytical, retrospective cohort study from 2007 to June 2024. Patients with EOE at diagnosis or during follow-up were identified. Epidemiological characteristics, tumor dimensions, timing of EOE, metastasis occurrence, and survival data were analyzed. Results: A total of 181 patients diagnosed with uveal melanoma were included, of whom twelve (6.62%) presented EOE , and 54.5% were male. The mean age was 64.41 years (SD 14.39). Average tumor thickness was 8.97 mm (SD 4.59), and average largest basal diameter was 17.57 mm (SD 4.18). Six patients (50%) had EOE at diagnosis, while six developed it during follow-up. The median time to event was 31.5 months (range: 8–120 months). Among these 12 patients, three developed metastases within the first year after diagnosis and treatment. Conclusions: EOE is a poor prognostic factor and tends to occur in larger tumors. It may be present at diagnosis or appear years later, reinforcing the need for long-term surveillance. Early identification is crucial to ensure appropriate treatment.