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Controversies |

The Future Promise and the Current Reality of Genetic Prognostication in Patients With Uveal Melanoma

Tony Tsai, MD; Joan M. O’Brien, MD
Arch Ophthalmol. 2008;126(3):413-415. doi:10.1001/archopht.126.3.413.
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Despite the widespread application of highly successful treatments for achieving local tumor control, long-term survival rates for uveal melanoma have remained unchanged, because patients continue to succumb to metastatic disease.1 Data from long-term follow-up in patients with all types and sizes of uveal melanoma reveal that up to half will eventually die from metastases.2 Melanomas are notorious for early dissemination, and doubling time analysis suggests that most metastases occur years before the ocular tumor is diagnosed and treated.3 While this may be true, it is certainly not the case for all subsets of patients with uveal melanoma. Less than 20% of patients with medium-sized tumors in the Collaborative Ocular Melanoma Study died from histopathologically confirmed metastatic disease at 10 years of follow-up.4 Clinical and histologic risk factors for metastatic disease are well recognized. These include increased basal tumor dimensions, ciliary body involvement, the presence of extrascleral extension, and epithelioid cell type.5

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