Liver metastasis in uveal melanoma — treatment options and clinical outcome
Uveal melanoma (UM) is the most prevalent primary intraocular malignancy in adults with a stable incidence rate between five and seven cases per million in Europe and the United States. Although UM and melanoma from other sites have the same origin, UM has different epidemiological, biological, path...
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Language: | English |
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IMR Press
2022-02-01
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Series: | Frontiers in Bioscience-Landmark |
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Online Access: | https://www.imrpress.com/journal/FBL/27/2/10.31083/j.fbl2702072 |
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author | Snježana Kaštelan Danijela Mrazovac Zimak Mira Ivanković Irena Marković Antonela Gverović Antunica |
author_facet | Snježana Kaštelan Danijela Mrazovac Zimak Mira Ivanković Irena Marković Antonela Gverović Antunica |
author_sort | Snježana Kaštelan |
collection | DOAJ |
description | Uveal melanoma (UM) is the most prevalent primary intraocular malignancy in adults with a stable incidence rate between five and seven cases per million in Europe and the United States. Although UM and melanoma from other sites have the same origin, UM has different epidemiological, biological, pathological and clinical features including characteristic metastatic hepatotropism. Despite improvements in the treatment of primary tumours, approximately 50% of patients with UM will develop metastases. In 90% of cases the liver is the first site of metastasis, however the mechanisms underlying this hepatic tropism have not been elucidated. Metastatic disease is associated with a very poor prognosis with a median overall survival of 6 to 12 months. Currently, there is no standard systemic treatment available for metastatic UM and once liver metastases have developed, prognosis is relatively poor. In order to prolong survival, close follow-up in all patients with UM is recommended for early detection and treatment. The treatment of metastatic UM includes systemic chemotherapy, immunotherapy and molecular targeted therapy. Liver-directed therapies, such as resection, radioembolization, chemoembolization, immunoembolization, isolated and percutaneous liver perfusion as well as thermal ablation represent available treatment options. However, to date a consensus regarding the optimal method of treatment is still lacking and the importance of setting guidelines in the treatment and management of metastatic UM is becoming a priority. Improvement in knowledge and a better insight into tumour biology, immunology and metastatic mechanism may improve current treatment methods and lead to the development of new strategies paving the way for a personalized approach. |
first_indexed | 2024-12-21T10:50:12Z |
format | Article |
id | doaj.art-a41c7bcd293648cf97c08964ab714bcf |
institution | Directory Open Access Journal |
issn | 2768-6701 |
language | English |
last_indexed | 2024-12-21T10:50:12Z |
publishDate | 2022-02-01 |
publisher | IMR Press |
record_format | Article |
series | Frontiers in Bioscience-Landmark |
spelling | doaj.art-a41c7bcd293648cf97c08964ab714bcf2022-12-21T19:06:40ZengIMR PressFrontiers in Bioscience-Landmark2768-67012022-02-0127207210.31083/j.fbl2702072S2768-6701(22)00410-5Liver metastasis in uveal melanoma — treatment options and clinical outcomeSnježana Kaštelan0Danijela Mrazovac Zimak1Mira Ivanković2Irena Marković3Antonela Gverović Antunica4School of Medicine Univerity of Zagreb, Department of Ophthalmology, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Ophthalmology, University Hospital Centre Zagreb, 10000 Zagreb, CroatiaDepartment of Neurology, General Hospital Dubrovnik, 20000 Dubrovnik, CroatiaDepartment of Ophthalmology, Clinical Hospital Split, 21000 Split, CroatiaDepartment of Ophthalmology, General Hospital Dubrovnik, 20000 Dubrovnik, CroatiaUveal melanoma (UM) is the most prevalent primary intraocular malignancy in adults with a stable incidence rate between five and seven cases per million in Europe and the United States. Although UM and melanoma from other sites have the same origin, UM has different epidemiological, biological, pathological and clinical features including characteristic metastatic hepatotropism. Despite improvements in the treatment of primary tumours, approximately 50% of patients with UM will develop metastases. In 90% of cases the liver is the first site of metastasis, however the mechanisms underlying this hepatic tropism have not been elucidated. Metastatic disease is associated with a very poor prognosis with a median overall survival of 6 to 12 months. Currently, there is no standard systemic treatment available for metastatic UM and once liver metastases have developed, prognosis is relatively poor. In order to prolong survival, close follow-up in all patients with UM is recommended for early detection and treatment. The treatment of metastatic UM includes systemic chemotherapy, immunotherapy and molecular targeted therapy. Liver-directed therapies, such as resection, radioembolization, chemoembolization, immunoembolization, isolated and percutaneous liver perfusion as well as thermal ablation represent available treatment options. However, to date a consensus regarding the optimal method of treatment is still lacking and the importance of setting guidelines in the treatment and management of metastatic UM is becoming a priority. Improvement in knowledge and a better insight into tumour biology, immunology and metastatic mechanism may improve current treatment methods and lead to the development of new strategies paving the way for a personalized approach.https://www.imrpress.com/journal/FBL/27/2/10.31083/j.fbl2702072uveal melanomamolecular characteristicliver metastasischemotherapyimmunotherapyliver-directed therapyprognosisreview |
spellingShingle | Snježana Kaštelan Danijela Mrazovac Zimak Mira Ivanković Irena Marković Antonela Gverović Antunica Liver metastasis in uveal melanoma — treatment options and clinical outcome Frontiers in Bioscience-Landmark uveal melanoma molecular characteristic liver metastasis chemotherapy immunotherapy liver-directed therapy prognosis review |
title | Liver metastasis in uveal melanoma — treatment options and clinical outcome |
title_full | Liver metastasis in uveal melanoma — treatment options and clinical outcome |
title_fullStr | Liver metastasis in uveal melanoma — treatment options and clinical outcome |
title_full_unstemmed | Liver metastasis in uveal melanoma — treatment options and clinical outcome |
title_short | Liver metastasis in uveal melanoma — treatment options and clinical outcome |
title_sort | liver metastasis in uveal melanoma treatment options and clinical outcome |
topic | uveal melanoma molecular characteristic liver metastasis chemotherapy immunotherapy liver-directed therapy prognosis review |
url | https://www.imrpress.com/journal/FBL/27/2/10.31083/j.fbl2702072 |
work_keys_str_mv | AT snjezanakastelan livermetastasisinuvealmelanomatreatmentoptionsandclinicaloutcome AT danijelamrazovaczimak livermetastasisinuvealmelanomatreatmentoptionsandclinicaloutcome AT miraivankovic livermetastasisinuvealmelanomatreatmentoptionsandclinicaloutcome AT irenamarkovic livermetastasisinuvealmelanomatreatmentoptionsandclinicaloutcome AT antonelagverovicantunica livermetastasisinuvealmelanomatreatmentoptionsandclinicaloutcome |