Small Uveal Melanomas Not Always Harmless

Article: Small uveal melanomas ‘not always harmless,’ study finds
Source: University of Liverpool (U.K.), via ScienceDaily  and Retinal Physician
Published: May 19, 2021

Researchers from the Liverpool Ocular Oncology Centre conducted a retrospective case-control study demonstrating the benefit of early treatment in small high-risk uveal melanomas. According to the researchers, the current paradigm suggests that small uveal melanomas pose little threat to metastatic spread and, furthermore, that local treatment does not influence survival due to metastasis. They explain that prior studies were based on large tumors, and moreover, that very few genetic studies were understaken on small uveal melanomas in general, leading them to be labeled as safe. Based on data from 940 patients over a 7-year study period, the Liverpool researchers found that over a quarter of small uveal melanomas (≤2.5 mm thickness) have genetic abnormalities (such as monosomy 3 and several gene mutations in both monosomy and disomy 3) that categorize them as highly metastatic tumors. They therefore propose that these small uveal melanomas with a high genetic risk be treated early, as compared to observation, to improve patients' chances of survival. The first author of the study comments, "Liverpool is one of the only ocular oncology centres in the world that offers prognostic biopsies to all of its melanoma patients, and we have therefore collected a large molecular genetic cohort of small tumours. This is the first study to show that over a quarter of these smaller uveal melanomas have lethal genetic mutations, and suggests that we may be able to influence patient survival and mortality outcomes with earlier treatment of these small melanomas." Although the study is small and comparatively niche, the Liverpool Ocular Oncology Centre demonstrated how their "unique collection of tiny intraocular biopsies of small uveal melanomas with follow-up clinical data" improved understanding of ocular disease and patient outcomes.

My rating of this study: ⭐⭐⭐

Hussain RN, Coupland SE, Kalirai H, et al. "Small High-Risk Uveal Melanomas Have a Lower Mortality Rate." Cancers.  13(9):2267. 8 May 2021. https://doi.org/10.3390/cancers13092267