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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Main Authors: Snježana Kaštelan, Danijela Mrazovac Zimak, Mira Ivanković, Irena Marković, Antonela Gverović Antunica
Format: Article
Language:English
Published: IMR Press 2022-02-01
Series:Frontiers in Bioscience-Landmark
Subjects:
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.
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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
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AT danijelamrazovaczimak livermetastasisinuvealmelanomatreatmentoptionsandclinicaloutcome
AT miraivankovic livermetastasisinuvealmelanomatreatmentoptionsandclinicaloutcome
AT irenamarkovic livermetastasisinuvealmelanomatreatmentoptionsandclinicaloutcome
AT antonelagverovicantunica livermetastasisinuvealmelanomatreatmentoptionsandclinicaloutcome