PROGNOSIS AND TREATMENT OF DISSEMINATED UVEAL MELANOMA

Background: The clinical course of uveal melanoma differs greatly from that of cutaneous melanoma. Methods: Twenty-four patients with metast atic uveal melanoma (13 men and 11 women; median age at diagnosis, 56 years [range, 17-67 years]) were evaluated retrospectively. Results: M ain sites of metastases were liver (87%), lung (46%), bone (29%), and skin (17%). Median relapse-free survival time was 36 months (range, 5- 240 months). Median survival time after clinical detection of metastas es was 9 months (range, 1-54 months). Relapse-free survival time was s ignificantly greater in patients 50 years of age or younger. After man ifestation of metastases, the clinical course was more favorable in pa tients in whom the liver was either not involved at all or not among t he first sites of dissemination. These patients had a median survival time of 19 months, compared with 7 months for patients in whom the liv er was involved initially. First-line systemic treatment of metastatic disease yielded three cases of stable disease lasting 6-14 months, bu t no complete or partial response. Three patients received intraarteri al liver perfusion as first- or second-line treatment, resulting in on e partial response, which lasted 6 months. Conclusion: Treatment and p rognosis results of patients with metastatic uveal melanoma were poor, especially when the disseminated to the liver; survival time of appro ximately 9 months can be expected.