Clinical Diagnosis, Treatment, and Prognosis of Uveal Melanoma

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Causes, Screening and Diagnosis".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 973

Special Issue Editor


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Guest Editor
Department of Ophthalmology, Ocular Oncology and Vitreoretinal Service, Bellvitge University Hospital, L’Hospitalet de Llobregat, 08907 Barcelona, Spain
Interests: uveal-melanoma

Special Issue Information

Dear Colleagues,

Uveal melanoma (UM) is a rare intraocular cancer with an incidence of 4.2 cases per million each year. It is the most common primary intraocular malignancy in adults and the second most common form of melanoma after melanoma of the skin. Patients are usually treated with globe-conserving methods such as radiotherapy or surgical resections, but in the case of large tumors, enucleation is required.

Regardless of primary treatment and effective local tumor control, this cancer is associated with a high mortality rate. Approximately 50% of patients develop metastases, after a median time of 3.1 years following diagnosis of the primary lesion, mostly to the liver through hematogenous spread. Liver metastasis is lethal in the majority of patients, with an estimated survival rate of 6-12 months.

Tebentafusp, recently approved for the systemic treatment of metastatic lesions, has raised hope for these patients.

Minimally invasive methods, such as tumoral biopsies and recently liquid biopsies, would be extremely beneficial, allowing clinical and molecular prognostication, with the aim of early detection of metastases to increase the likelihood of adequate treatment to improve the survival of these patients.

In this Special Issue, experts in this field will review the current approaches to the diagnosis, management and prognosis of patients affected by UM.

Dr. Josep Maria Caminal Mitjana
Guest Editor

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Keywords

  • uveal melanoma
  • choroidal melanoma
  • gene expression profiling
  • immunotherapy
  • metastasis
  • radiotherapy
  • liquid biopsy
  • circulating tumor cells
  • brachytherapy
  • next-generation sequencing
  • proton therapy

Published Papers (2 papers)

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12 pages, 5438 KiB  
Article
Intralesional Vessel Diameter Measured by Optical Coherence Tomography Angiography Could Improve the Differential Diagnosis of Small Melanocytic Choroidal Lesions
by Laura Vigués-Jorba, Daniel Lorenzo, Cristina Pujadas, Rahul Morwani, Liria Yamamoto-Rodriguez, Maria Baradad-Jurjo, Lluis Arias, Estefania Cobos, Pere Garcia-Bru, Juan-Francisco Santamaria, Olga Garcia Garcia and Josep-Maria Caminal
Cancers 2024, 16(12), 2167; https://doi.org/10.3390/cancers16122167 - 7 Jun 2024
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Abstract
In this study, we aimed to identify the features of indeterminate choroidal melanocytic lesions visualized on optical coherence tomography angiography (OCTA) and to identify the predictors of growth. We retrospectively evaluated 86 patients with indeterminate lesions treated at our centre from 2016 to [...] Read more.
In this study, we aimed to identify the features of indeterminate choroidal melanocytic lesions visualized on optical coherence tomography angiography (OCTA) and to identify the predictors of growth. We retrospectively evaluated 86 patients with indeterminate lesions treated at our centre from 2016 to 2021. Clinical management involved active surveillance followed by brachytherapy if growth was detected. The lesions were classified into two groups according to whether they grew (small melanomas) or remained stable (choroidal nevi). Growth was detected in 19 (22.1%) lesions. All patients underwent OCTA at baseline. These images were compared to identify the possible predictors of growth. Significant between-group differences were observed in thickness (p = 0.00), greatest basal diameter (p = 0.00), number of risk factors (p = 0.00), symptoms (p = 0.001; relative risk [RR]: 4.3), orange pigment (p = 0.00; RR: 6.02), and ultrasonographic hollowness (Kappa sign); p = 0.000; RR: 5.3). The melanomas had significantly more vessels with a diameter ≥ 76.3 µm (p = 0.02; RR: 2.46). The time to growth in these lesions was significantly shorter (p = 0.05) than in lesions with smaller vessels. These findings show that vessel diameter quantified by OCTA can help differentiate between choroidal nevi and small melanomas, when considered together with clinical risk factors. Full article
(This article belongs to the Special Issue Clinical Diagnosis, Treatment, and Prognosis of Uveal Melanoma)
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12 pages, 2435 KiB  
Systematic Review
Impact of Driver Mutations on Metastasis-Free Survival in Uveal Melanoma: A Meta-Analysis
by David Lamas-Francis, Carmen Antía Rodríguez-Fernández, Elia de Esteban-Maciñeira, Paula Silva-Rodríguez, María Pardo, Manuel Bande-Rodríguez and María José Blanco-Teijeiro
Cancers 2024, 16(14), 2510; https://doi.org/10.3390/cancers16142510 - 10 Jul 2024
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Abstract
The prognosis of uveal melanoma is significantly influenced by the risk of metastasis, which varies according to clinical and genetic features. Driver mutations can predict the likelihood of disease progression and survival, although the data in the literature are inconsistent. This meta-analysis aimed [...] Read more.
The prognosis of uveal melanoma is significantly influenced by the risk of metastasis, which varies according to clinical and genetic features. Driver mutations can predict the likelihood of disease progression and survival, although the data in the literature are inconsistent. This meta-analysis aimed to evaluate the prognostic significance of driver mutations, including GNAQ, GNA11, BAP1, and SF3B1, in the advancement of uveal melanoma. A comprehensive search of databases yielded relevant studies, and data from 13 studies (848 eyes) were synthesized to assess the impact of these mutations on metastasis-free survival. The BAP1 mutation and negative immunohistochemistry were associated with a higher risk of metastasis (logHR = 1.44, 95% CI 1.05–1.83). GNAQ, GNA11, and SF3B1 mutations did not show a significant increase in risk. In summary, BAP1 has proven to reliably predict the likelihood of disease progression in uveal melanoma, while further studies are needed to establish the significance of other driver mutations. Full article
(This article belongs to the Special Issue Clinical Diagnosis, Treatment, and Prognosis of Uveal Melanoma)
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