Uveal melanoma continues to be one of the deadliest diseases encountered in ophthalmology, with many patients dying of metastatic disease. Despite improvements in diagnosis and treatment of the primary tumor, there has not been a corresponding improvement in survival.1 This inability to prevent metastatic disease appears to be due to clinically undetectable micrometastasis occurring before the primary tumor is treated and becoming clinically manifest only months to years later.2 As a result, survival from uveal melanoma is unlikely to improve in the foreseeable future solely through incremental improvements in managing the primary tumor. Concurrently, there are no existing therapies, or new ones on the horizon, with a reasonable prospect of improving survival in patients with advanced metastatic melanoma, so waiting for overt metastatic disease to manifest before initiating systemic therapy will continue to be of limited value. If patients with uveal melanoma are to live longer, new approaches will be required to identify high-risk patients and intervene earlier to delay or prevent metastatic disease.
Harbour JW. Molecular Prognostic Testing in Uveal Melanoma: Has It Finally Come of Age? Arch Ophthalmol. 2007;125(8):1122–1123. doi:10.1001/archopht.125.8.1122
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