Uveal melanoma: an overview of management and prognosis

Sa？etak Uveal melanoma represents 5% of all melanomas and the eye is the second most common site for primary melanoma after the skin. Delays or failure to make an accurate and early diagnosis may have fatal consequences. Advances in the diagnosis and local and systemic treatment of uveal melanoma in recent times have caused a shift from enucleation to eye-conserving treatment modalities. Currently, radiotherapy is the most commonly used therapeutic option, which can include: brachytherapy- radioactive plaque, as the most frequently used form, than stereotactic external beam radiotherapy-radiosurgery as well as proton therapy, as a form of charged-particle radiotherapy. However, surgery as an inevitable therapeutic option has to be performed in some cases. In the treatment of primary tumor, local treatment methods are effective in preventing local recurrence in over 95% of cases. However, metastatic disease develops in up to 50% of patients, with liver metastases, as the most common. At this stage of the disease there is a poor survival rate of the patients (4-15 months) and this has remained relatively unchanged over the past decades. Although potential therapeutic targets have been identified, there is no currently effective treatment of metastatic disease. Pending clinical trials involving chemotherapeutic, immunotherapeutic and molecularly targeted agents offer hope for successful tumor control and vision preservation as well as metastases prevention and improvement of overall patient survival