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Romanowska-Dixon B, Nowak MS, Śmigielski J, Dębicka-Kumela M. Impact of the SARS-CoV-2 (COVID-19) Pandemic on Characteristics and Management of Uveal Melanoma in the National Referral Center in Poland. Cancers (Basel) 2024; 16:2061. [PMID: 38893180 PMCID: PMC11171075 DOI: 10.3390/cancers16112061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 05/20/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: to analyze the impact of the COVID-19 pandemic on the characteristics and management of uveal melanoma (UM) in the National Referral Center in Poland. (2) Materials and Methods: the retrospective analysis of 1336 patients who were newly diagnosed with UM at the Department of Ophthalmology and Ophthalmic Oncology, Jagiellonian University Collegium Medicum Krakow, Poland between 1 January 2018 and 31 December 2021. The demographic and clinical data were compiled, including localization, size, and treatment methods of tumors. (3) Results: In total, 728 patients with UM were included before the COVID-19 pandemic, in the years 2018-2019, and 608 were included during the COVID-19 pandemic, in the years 2020-2021. Fixed-base dynamics indicators for the incidence of uveal melanoma (base year 2018) in the National Referral Center in Poland were 80.22% and 86.81% in the years 2020 and 2021, respectively. UMs were statistically significantly larger and more frequently localized anterior to the equator of the eye globe in the year 2021 than in the year 2018 (Chi-square Pearson test p = 0.0001 and p = 0.0077, respectively). The rate of patients treated with enucleation increased from 15.94% in the year 2018 to 26.90% in the year 2021 (Chi-square Pearson test p = 0.0005). (4) Conclusions: Statistically significant differences were found in the management of uveal melanoma in the National Referral Center in Poland during the COVID-19 pandemic with tumors being larger, more frequently localized anterior to the equator of the eye globe, and more often enucleated.
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Affiliation(s)
- Bożena Romanowska-Dixon
- Department of Ophthalmology, Jagiellonian University Collegium Medicum, 38 Kopernika Str., 31-501 Krakow, Poland; (B.R.-D.); (M.D.-K.)
- Ophthalmology and Ophthalmic Oncology Clinic, University Hospital, 38 Kopernika Str., 31-501 Krakow, Poland
| | - Michał Szymon Nowak
- Institute of Optics and Optometry, University of Social Science, 121 Gdanska Str., 90-519 Lodz, Poland
- Provisus Eye Clinic, 112 Redzinska Str., 42-209 Czestochowa, Poland
| | - Janusz Śmigielski
- Department of Statistics, State University of Applied Science in Konin, 1 Przyjazni Str., 65-510 Konin, Poland;
| | - Magdalena Dębicka-Kumela
- Department of Ophthalmology, Jagiellonian University Collegium Medicum, 38 Kopernika Str., 31-501 Krakow, Poland; (B.R.-D.); (M.D.-K.)
- Ophthalmology and Ophthalmic Oncology Clinic, University Hospital, 38 Kopernika Str., 31-501 Krakow, Poland
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2
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Liu X, Yue H, Jiang S, Kong L, Xu Y, Chen Y, Wang C, Wang Y, Zhu X, Kong Y, Zhang X, Qian J, Luo Z. Clinical features and prognosis of patients with metastatic ocular and orbital melanoma: A bi-institutional study. Cancer Med 2023; 12:16163-16172. [PMID: 37409486 PMCID: PMC10469730 DOI: 10.1002/cam4.6273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/14/2023] [Accepted: 05/06/2023] [Indexed: 07/07/2023] Open
Abstract
PURPOSE Metastatic ocular and orbital melanomas are extremely rare. The clinical characteristics and standard treatments for these patients are not fully established. MATERIALS AND METHODS We retrospectively analyzed patients with metastatic ocular and orbital melanoma from Fudan University Shanghai Cancer Center and Eye & ENT Hospital of Fudan University between January 2012 and May 2022. RESULTS Overall, 51 patients with metastatic ocular and orbital melanoma were included. The most common primary sites were uvea (73%), followed by conjunctiva (22%), lacrimal sac (4%), and orbit (2%). Patients with uveal melanoma (UM) had a significantly younger age (48 vs. 68 years, p < 0.001), higher incidence of liver metastases (89% vs. 9%, p<0.001), a lower incidence of lymph nodes metastases (16% vs. 46%, p = 0.043) and a lower incidence of BRAF mutation (0% vs. 55%, p<0.001) compared with patients with conjunctival melanoma (CM). The overall response rate of the first-line treatment was 18%. Three of the four patients with BRAF-mutated CM responded to dabrafenib and trametinib treatment. The median progression-free survival (PFS) and overall survival (OS) of first-line treatment were 5.1 and 11.9 months, respectively. Among patients with liver metastases, liver-directed treatment was correlated with better patient PFS (p < 0.001) and OS (p < 0.001) after adjusting for number of metastatic sites and primary sites. CONCLUSION CM and UM have different characteristics. Patient with CM had a high incidence of BRAF mutation, and the treatment of BRAF and MEK inhibitors conferred clinical benefit. Liver directed therapies had a potential benefit in disease control in patients with liver metastases.
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Affiliation(s)
- Xin Liu
- Department of Head & Neck tumors and Neuroendocrine tumorsFudan University Shanghai Cancer CenterShanghaiChina
- Department of OncologyShanghai Medical College, Fudan UniversityShanghaiChina
| | - Han Yue
- Department of OphthalmologyEye & ENT Hospital of Fudan UniversityShanghaiChina
| | - Shiyu Jiang
- Department of OncologyShanghai Medical College, Fudan UniversityShanghaiChina
- Department of LymphomaFudan University Shanghai Cancer CenterShanghaiChina
| | - Lin Kong
- Department of Radiation Oncology, Shanghai Proton and Heavy Ion CenterFudan University Cancer HospitalShanghaiChina
- Shanghai Key Laboratory of radiation oncologyShanghaiChina
- Shanghai Engineering Research Center of Proton and Heavy Ion Radiation TherapyShanghaiChina
| | - Yu Xu
- Department of OncologyShanghai Medical College, Fudan UniversityShanghaiChina
- Department of Musculoskeletal OncologyFudan University Shanghai Cancer CenterShanghaiChina
| | - Yong Chen
- Department of OncologyShanghai Medical College, Fudan UniversityShanghaiChina
- Department of Musculoskeletal OncologyFudan University Shanghai Cancer CenterShanghaiChina
| | - Chunmeng Wang
- Department of OncologyShanghai Medical College, Fudan UniversityShanghaiChina
- Department of Musculoskeletal OncologyFudan University Shanghai Cancer CenterShanghaiChina
| | - Yan Wang
- Department of OncologyShanghai Medical College, Fudan UniversityShanghaiChina
- Department of Radiation OncologyFudan University Shanghai Cancer CenterShanghaiChina
| | - Xiaoli Zhu
- Department of OncologyShanghai Medical College, Fudan UniversityShanghaiChina
- Department of PathologyFudan University Shanghai Cancer CenterShanghaiChina
| | - Yunyi Kong
- Department of OncologyShanghai Medical College, Fudan UniversityShanghaiChina
- Department of PathologyFudan University Shanghai Cancer CenterShanghaiChina
| | - Xiaowei Zhang
- Department of OncologyShanghai Medical College, Fudan UniversityShanghaiChina
- Department of gastrointestinal medical oncologyFudan University Shanghai Cancer CenterShanghaiChina
| | - Jiang Qian
- Department of OphthalmologyEye & ENT Hospital of Fudan UniversityShanghaiChina
| | - Zhiguo Luo
- Department of OncologyShanghai Medical College, Fudan UniversityShanghaiChina
- Department of gastrointestinal medical oncologyFudan University Shanghai Cancer CenterShanghaiChina
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Brănișteanu DE, Porumb-Andrese E, Stărică A, Munteanu AC, Toader MP, Zemba M, Porumb V, Cozmin M, Moraru AD, Nicolescu AC, Brănișteanu DC. Differences and Similarities in Epidemiology and Risk Factors for Cutaneous and Uveal Melanoma. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050943. [PMID: 37241175 DOI: 10.3390/medicina59050943] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/17/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Both cutaneous melanoma (CM) and uveal melanoma (UM) represent important causes of morbidity and mortality. In this review, we evaluate the available knowledge on the differences and similarities between cutaneous melanoma and uveal melanoma, focusing on the epidemiological aspects and risk factors. Uveal melanoma is a rare condition but is the most prevalent primary intra-ocular malignant tumor in adults. Cutaneous melanoma, on the other hand, is significantly more common. While the frequency of cutaneous melanoma has increased in the last decades worldwide, the incidence of uveal melanoma has remained stable. Although both tumors arise from melanocytes, they are very distinct entities biologically, with complex and varied etiologies. Both conditions are encountered more frequently by individuals with a fair phenotype. ultraviolet-radiation is an important, well-documented risk factor for the development of CM, but has shown not to be of specific risk in UM. Although cutaneous and ocular melanomas seem to be inherited independently, there are reported cases of concomitant primary tumors in the same patient.
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Affiliation(s)
- Daciana Elena Brănișteanu
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Elena Porumb-Andrese
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Alexandra Stărică
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | - Anca Catalina Munteanu
- Dermatology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
- Railway Clinical Hospital, 700506 Iasi, Romania
| | | | - Mihail Zemba
- Ophthalmology Department, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Vlad Porumb
- Department Surgery, 'Grigore T. Popa' University of Medicine and Pharmacy, 700111 Iasi, Romania
| | - Mihai Cozmin
- Clinical Department, Apollonia University of Iasi, 700511 Iasi, Romania
| | - Andreea Dana Moraru
- Ophthalmology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alin Codruț Nicolescu
- Roma Medical Center for Diagnosis and Treatment, 011773 Bucharest, Romania
- "Agrippa Ionescu" Emergency Clinical Hospital, 011773 Bucharest, Romania
| | - Daniel Constantin Brănișteanu
- Railway Clinical Hospital, 700506 Iasi, Romania
- Ophthalmology Department, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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Romanowska-Dixon B, Dębicka-Kumela M, Śmigielski J, Nowak MS. Sex Differences in the Treatment of Uveal Melanoma in a Group of 1336 Patients. J Pers Med 2023; 13:jpm13020353. [PMID: 36836586 PMCID: PMC9967634 DOI: 10.3390/jpm13020353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023] Open
Abstract
(1) Background: The aim of this study was to analyze the sex differences in the treatment of uveal melanoma (UM) in a group of 1336 patients from a national referral center during the period 2018-2021. (2) Materials and Methods: The study was designed in a retrospective manner. A total of 1336 patients who were newly diagnosed with UM at the Department of Ophthalmology and Ophthalmic Oncology, Jagiellonian University Collegium Medicum, Krakow, Poland, between 1 January 2018 and 31 December 2021, were included in the study. The demographic and clinical data were compiled, including the sex of patients and the treatment methods. (3) Results: In total, 1336 patients with ocular melanoma were identified, including 726 women (54.34%) and 610 men (45.66%). A total of 49.70% of tumors were localized in the right eye and 50.30% in the left eye. UMs were localized statistically significantly more frequently posterior to the equator of the eye globe in men than in women (79.67% vs. 74.10%, Chi^2 Pearson test p = 0.035). Tumors tended to be larger in men, but this difference was not clinically significant. Men were enucleated more often than women (23.44% vs. 18.04%, Chi^2 Pearson test p = 0.015). (4) Conclusions: Statistically significant sex differences were found in the treatment of uveal melanoma in a national referral center in Poland, with men being enucleated more often than women.
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Affiliation(s)
- Bożena Romanowska-Dixon
- Department of Ophthalmology and Ophthalmic Oncology, Jagiellonian University Collegium Medicum, 38 Kopernika Str., 31-501 Krakow, Poland
| | - Magdalena Dębicka-Kumela
- Department of Ophthalmology and Ophthalmic Oncology, Jagiellonian University Collegium Medicum, 38 Kopernika Str., 31-501 Krakow, Poland
| | - Janusz Śmigielski
- Department of Statistics, State University of Applied Science in Konin, 1 Przyjazni Str., 65-510 Konin, Poland
| | - Michał Szymon Nowak
- Institute of Optics and Optometry, University of Social Science, 121 Gdanska Str., 90-519 Lodz, Poland
- Provisus Eye Clinic, 112 Redzinska Str., 42-209 Czestochowa, Poland
- Correspondence: ; Tel.: +48-888-80-10
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5
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Teoh CY, W Md Kasim WM, Norlaila T. Choroidal Melanoma: A Case Series From Malaysia. Cureus 2022; 14:e31105. [DOI: 10.7759/cureus.31105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2022] [Indexed: 11/06/2022] Open
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6
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Kestel S, Göçün FPU, Öğüt B, Erdem Ö. Clinicopathologic features and survival outcomes of ocular melanoma: a series of 31 cases from a tertiary university hospital. J Pathol Transl Med 2022; 56:187-198. [PMID: 35501671 PMCID: PMC9288897 DOI: 10.4132/jptm.2022.03.10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 03/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background We aimed to determine the effect of clinicopathologic features on overall survival among Caucasian ocular melanoma patients in the Central Anatolia region of Turkey. Methods This single-center study included conjunctival (n = 12) and uveal (n = 19) melanoma patients diagnosed between January 2008 and March 2020. Clinicopathologic features and outcomes were reviewed retrospectively. Five cases were tested for BRAF V600 mutations with real-time polymerase chain reaction, and one case was tested with next-generation sequencing. Survival was calculated using the Kaplan-Meier method. Results Thirty-one patients had a mean initial age of 58.32 years (median, 61 years; range 25 to 78 years). There were 13 male and 18 female patients. The median follow-up time was 43.5 months (range, 6 to 155 months) for conjunctival melanoma and 35 months (range, 8 to 151 months) for uveal melanoma. When this study ended, eight of the 12 conjunctival melanoma patients (66.7%) and nine of the 19 uveal melanoma patients (47.4%) had died. The presence of tumor-infiltrating lymphocytes was related to improved overall survival in conjunctival melanoma (p = .014), whereas the presence of ulceration (p = .030), lymphovascular invasion (p = .051), tumor in the left eye (p = .012), tumor thickness of > 2 mm (p = .012), and mitotic count of >1/mm2 (p = .012) reduced the overall survival in conjunctival melanoma. Uveal melanoma tumors with the largest diameter of 9.1–15 mm led to the lowest overall survival among subgroups (p = .035). Involvement of the conjunctiva (p=.005) and lens (p = .003) diminished overall survival in uveal melanoma. BRAF V600 mutation was present in one case of conjunctival melanoma, GNAQ R183Q mutation was present in one case of uveal melanoma. Patients with uveal melanoma presented with an advanced pathological tumor stage compared to those with conjunctival melanoma (p = .019). Conclusions This study confirmed the presence of tumor-infiltrating lymphocytes as a favorable factor in conjunctival melanoma and conjunctival and lens involvement as unfavorable prognostic factors in uveal melanoma for overall survival, respectively.
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Affiliation(s)
- Selin Kestel
- Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | | | - Betül Öğüt
- Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey
| | - Özlem Erdem
- Department of Pathology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Gonzalez-H Leon A, Chavez Y, Kamil ZS, Ghazarian D, Krema H. Diagnosis of the origin of an epibulbar melanocytic tumor with molecular genomics. Ophthalmic Genet 2022; 43:518-521. [PMID: 35258412 DOI: 10.1080/13816810.2022.2039719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Uveal melanoma (UM) and conjunctival melanoma (CM) are distinct entities with different etiologies and genetic background. We present a case of an atypical subconjunctival melanoma arising from a blue nevus. PATIENTS AND METHODS A 61-year-old female presented with a partially melanocytic epibulbar mass with surrounding episcleral pigmented spots. The lesion was detached from the overlying conjunctiva without an intraocular component. Excisional biopsy revealed a predominantly epithelioid melanoma, that was suggested to be metastasic, although there was no evidence of a primary melanoma elsewhere. RESULTS Molecular analysis identified GNAQ and BAP1 pathogenic variants, which strongly suggested the diagnosis as a primary epibulbar melanoma arising from episcleral blue nevus. CONCLUSION This case demonstrates the value of tumor molecular analysis using Next Generation Sequencing (NGS) for differentiating the origin of an unusually located ocular melanoma.
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Affiliation(s)
- Ana Gonzalez-H Leon
- Ocular Oncology Service, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Yael Chavez
- Ocular Oncology Service, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Zaid Saeed Kamil
- Laboratory Medicine & Pathobiology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada
| | - Danny Ghazarian
- Laboratory Medicine & Pathobiology, Princess Margaret Hospital Cancer Centre, Toronto, Ontario, Canada
| | - Hatem Krema
- Ocular Oncology Service, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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Huang YY, Hou TY, Yu WK, Tsai CC, Kao SC, Hsu WM, Liu JL(C. The Clinical Feature and Treatment Outcome of Ocular Melanoma: A 34-Year Experience in a Tertiary Referral Center. Cancers (Basel) 2021; 13:cancers13235926. [PMID: 34885033 PMCID: PMC8657155 DOI: 10.3390/cancers13235926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
Malignant melanoma can arise from melanocytes in various structures of the eye, orbit, and ocular adnexa. We reviewed the clinical features and long-term results of all subjects with histologically proved melanoma originating from any of the ocular and periocular structures in a tertiary referral center. Overall, 88 patients including 47 men were recruited. The tumor was primarily located in the uvea, followed by the conjunctiva, orbit, eyelid, and lacrimal sac. Patients with uveal melanoma were diagnosed at a relatively younger age (47.0 years), while those with orbital and eyelid melanomas were older at presentation (79.5 years and 78.5 years, respectively). The overall local recurrence rate was 9% at a median follow-up of 41.0 months, among which orbital and eyelid melanomas recurred most commonly. The overall mortality rate was 41% in a median duration of 27.2 months (IQR, 13-58 months) from diagnosis, with the highest for lacrimal sac melanoma, followed by melanoma of the orbit, uveal, conjunctiva, and eyelid. Despite prompt local control, the risk for metastasis and mortality was high. Therefore, efficient modalities for early diagnosis and treatment of ocular melanoma are necessary.
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Affiliation(s)
- Yu-Yun Huang
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (Y.-Y.H.); (T.-Y.H.); (W.-K.Y.); (S.-C.K.); (W.-M.H.); (J.-L.L.)
- School of Medicine, National Yang Ming University, Taipei 11221, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Tzu-Yu Hou
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (Y.-Y.H.); (T.-Y.H.); (W.-K.Y.); (S.-C.K.); (W.-M.H.); (J.-L.L.)
- School of Medicine, National Yang Ming University, Taipei 11221, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
- Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
| | - Wei-Kuang Yu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (Y.-Y.H.); (T.-Y.H.); (W.-K.Y.); (S.-C.K.); (W.-M.H.); (J.-L.L.)
- School of Medicine, National Yang Ming University, Taipei 11221, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Chieh-Chih Tsai
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (Y.-Y.H.); (T.-Y.H.); (W.-K.Y.); (S.-C.K.); (W.-M.H.); (J.-L.L.)
- School of Medicine, National Yang Ming University, Taipei 11221, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
- Correspondence: ; Tel.: +886-2-28-757-325
| | - Shu-Ching Kao
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (Y.-Y.H.); (T.-Y.H.); (W.-K.Y.); (S.-C.K.); (W.-M.H.); (J.-L.L.)
- School of Medicine, National Yang Ming University, Taipei 11221, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Wen-Ming Hsu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (Y.-Y.H.); (T.-Y.H.); (W.-K.Y.); (S.-C.K.); (W.-M.H.); (J.-L.L.)
- School of Medicine, National Yang Ming University, Taipei 11221, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
- Department of Ophthalmology, Taipei Medical University-Shuang-Ho Hospital, Ministry of Health and Welfare, New Taipei City 23561, Taiwan
| | - Jui-Ling (Catherine) Liu
- Department of Ophthalmology, Taipei Veterans General Hospital, Taipei 11217, Taiwan; (Y.-Y.H.); (T.-Y.H.); (W.-K.Y.); (S.-C.K.); (W.-M.H.); (J.-L.L.)
- School of Medicine, National Yang Ming University, Taipei 11221, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
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9
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Branisteanu DC, Bogdanici CM, Branisteanu DE, Maranduca MA, Zemba M, Balta F, Branisteanu CI, Moraru AD. Uveal melanoma diagnosis and current treatment options (Review). Exp Ther Med 2021; 22:1428. [PMID: 34707709 PMCID: PMC8543295 DOI: 10.3892/etm.2021.10863] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/25/2021] [Indexed: 12/11/2022] Open
Abstract
Uveal melanoma is a rare condition accounting for only 5% of all primary melanoma cases. Still, it is the most frequently diagnosed primary intraocular malignant tumor in adults. Almost 90% of the tumors involve the choroid and only a small percentage affects the ciliary body or the iris. There is a consistent difference in incidence between different regions with individuals of northern European descent having a significantly higher risk as compared to Hispanics, Asians, and Blacks. Among the many risk factors, mutations in the G protein subunit alpha Q (GNAQ) or G protein subunit alpha 11 (GNA11) genes and different receptors are highly suggestive. While iris melanoma can easily be noticed by the patient itself or diagnosed at a routine slit-lamp evaluation, a consistent percentage of posterior uveal tumors are incidentally diagnosed at funduscopic evaluation as they can evolve silently for years, especially if located in the periphery. Uveal melanoma classifications rely on the tumor size (thickness and basal diameter) and also on intraocular and extraocular extension. The differential diagnosis with pseudomelanomas is carried out according to the tumor aspect and position. Iris melanoma has a better prognosis and a lower mortality rate as compared to choroidal melanoma that has a much higher rate of metastasis (50% of the patients) and a subsequent limited life expectancy from 6 to 12 months. While conservative therapeutic options for the primary tumor, relying on different surgical excision techniques and/or irradiation therapies, offer good local tumor control, the treatment options for metastatic disease, although numerous, are still inadequate in preventing a fatal outcome.
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Affiliation(s)
| | | | - Daciana Elena Branisteanu
- Department of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Minela Aida Maranduca
- Department of Physiology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihail Zemba
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Florian Balta
- Department of Ophthalmology, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | - Andreea Dana Moraru
- Department of Ophthalmology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
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Wang MM, Chen C, Lynn MN, Figueiredo CR, Tan WJ, Lim TS, Coupland SE, Chan ASY. Applying Single-Cell Technology in Uveal Melanomas: Current Trends and Perspectives for Improving Uveal Melanoma Metastasis Surveillance and Tumor Profiling. Front Mol Biosci 2021; 7:611584. [PMID: 33585560 PMCID: PMC7874218 DOI: 10.3389/fmolb.2020.611584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 11/25/2020] [Indexed: 12/21/2022] Open
Abstract
Uveal melanoma (UM) is the most common primary adult intraocular malignancy. This rare but devastating cancer causes vision loss and confers a poor survival rate due to distant metastases. Identifying clinical and molecular features that portend a metastatic risk is an important part of UM workup and prognostication. Current UM prognostication tools are based on determining the tumor size, gene expression profile, and chromosomal rearrangements. Although we can predict the risk of metastasis fairly accurately, we cannot obtain preclinical evidence of metastasis or identify biomarkers that might form the basis of targeted therapy. These gaps in UM research might be addressed by single-cell research. Indeed, single-cell technologies are being increasingly used to identify circulating tumor cells and profile transcriptomic signatures in single, drug-resistant tumor cells. Such advances have led to the identification of suitable biomarkers for targeted treatment. Here, we review the approaches used in cutaneous melanomas and other cancers to isolate single cells and profile them at the transcriptomic and/or genomic level. We discuss how these approaches might enhance our current approach to UM management and review the emerging data from single-cell analyses in UM.
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Affiliation(s)
- Mona Meng Wang
- Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore
| | - Chuanfei Chen
- Cytogenetics Laboratory, Department of Molecular Pathology, Singapore General Hospital, Singapore, Singapore
| | - Myoe Naing Lynn
- Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore
| | - Carlos R. Figueiredo
- MediCity Research Laboratory and Institute of Biomedicine, University of Turku, Turku, Finland
| | - Wei Jian Tan
- A. Menarini Biomarkers Singapore Pte Ltd, Singapore, Singapore
| | - Tong Seng Lim
- A. Menarini Biomarkers Singapore Pte Ltd, Singapore, Singapore
| | - Sarah E. Coupland
- Department of Molecular and Clinical Cancer Medicine, ITM, University of Liverpool, Liverpool, United Kingdom
- Liverpool Clinical Laboratories, Royal Liverpool University Hospital, Liverpool, United Kingdom
| | - Anita Sook Yee Chan
- Singapore National Eye Centre and Singapore Eye Research Institute, Singapore, Singapore
- Duke-Nus Medical School, Singapore, Singapore
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