Molecular prognostic testing in uveal melanoma

Abstract

Uveal melanoma is the most common primary intraocular malignancy and it has a strong propensity for hematogenous metastasis to the liver and elsewhere. Despite substantial improvements in the diagnosis and treatment of the primary tumor over the past 50 years, there has not been a concomitant improvement in survival, indicating that our understanding of this cancer is still incomplete. Recently, however, research into the molecular pathobiology of uveal melanoma has provided new insights that may explain these clinical shortcomings and will soon usher in a new era of clinical management that promises to improve patient outcomes. Indeed, recent research has made uveal melanoma a model cancer for the concept of individualized, information-driven clinical decision-making based on predictive risk assessment and pre-emptive therapy. This article summarizes current clinical management of uveal melanoma and its limitations, describes traditional clinical and histopathological prognostic factors and presents a new molecular prognostic approach that could have important implications for future clinical management.

Keywords::

• choroidal melanoma
• fine needle aspiration biopsy
• gene expression profiling
• metastasis
• molecular prognostic test uveal melanoma
• monosomy 3
• prognosis