Uveal Melanoma—Where are We Going?

Despite good local tumor control, about 50% of patients affected by uveal melanoma die of their disease. Poor prognosis has been related to increased patient age, larger tumor size, ciliary body involvement, epithelioid cell type, extraocular extension, lymphocytic infiltration and high mitotic rate. In recent years, cytogenetic analysis has shown a strong impact on the management of these patients. Since monosomy of chromosome 3 proved to be a high predictive factor for metastatic disease, more ocular oncologists perform tumor biopsy almost routinely. However, there are still controversies regarding these results, such as sampling errors, mainly of disomy 3 results; the impact on quality of life; and the presence of other chromosomal abnormalities that correlate with prognosis as recently described in the literature (e.g. chromosomes 6, 8, 15 and 18). New classification of uveal melanomas as class 1 or class 2 tumors, indicating low and high risk for metastasis, respectively, has also been proposed using gene expression profiles.