Purpose: To clarify the clinical features, treatment, and outcomes of patients with uveal melanoma
Method: We retrospectively analyzed the medical records of 285 patients diagnosed with uveal melanoma between April 2004 and March 2019.
Results: The mean age of the patients at diagnosis was 56.7 years. Four patients suffered from ipsilateral nevus of Ota, and fifteen patients suffered from other malignant tumors. The initial treatment included enucleation of the eyeball (103 cases), brachytherapy (78 cases), carbon-ion radiotherapy (38 cases), and stereotactic radiotherapy (18 cases). The 5-year recurrence-free survival rate was 62.0%, and the 5-year ocular survival rate was 76.1% in patients who underwent eye-preservation treatment. We found that 30.5% of the eyes maintained visual acuity comparable with pre-treatment ones. The 5-year disease-specific survival rate was 87.1%, and the 5-year cumulative metastasis rate was 27.0%. The 1-, 2-, and 5-year survival rates after the diagnosis of metastasis was 79.7%, 55.2%, and 46.4%, respectively, and some patients treated with immune-checkpoint inhibitors survived for a long term.
Conclusions: Our results indicated that eye-preservation treatment prevented enucleation in 76.1% of the eyes but visual acuity was decreased in many eyes. Although 27.0% of patients suffered from distant metastasis 5 years after treatment, survival rate after the detection of metastasis were better than those of reported case series.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 765-775, 2020.