Uveal melanoma (UM) is an aggressive intraocular malignancy, and despite advances in the local methods of treatment of primary UM, the survival rates have not improved. (1) This is thought to be due to the tumour's proclivity for early occult micro-metastasis, which is undetectable at the time of diagnosis and treatment of the primary tumour. (2,3) At present, there are no effective chemotherapeutic agents for metastatic UM, (3) with death rates from melanoma-related metastasis at 80% at one year and 92% at two years. (4) The most common primary intraocular tumour in Caucasian adults is UM. The reported age-standardised incidence rate in the United States and Europe is 5.1 per million (5) and 2.6-7.5 per million, respectively. In contrast, the age-standardised incidence rate in South Korea and Japan is 0.6 per million (6) and 0.2 per million, (7) respectively. The literature on the clinicopathologic spectrum of UM is largely derived from a Western setting. In the Collaborative Ocular Melanoma Study (COMS), as well as a more recently published series of 8,100 patients with UM, 97%-98% of patients were Caucasian, with Asian patients representing < 1% of patients in both cohorts. (8,9) Aside from significant epidemiological heterogeneity, there is also marked biological diversity in UM. In recent years, the genetic abnormalities in UMs have been found to be distinct from those in cutaneous melanomas. In contrast to cutaneous melanomas, UMs lack mutations in B rapidly accelerated fibrosarcoma (BRAF), neuroblastoma rapidly accelerated sarcoma (NRAS) and Kit genes. (2,10) Instead, mutations in guanine nucleotide-binding protein subunit alpha-Q (GNAQ) and guanine nucleotide-binding protein subunit alpha-11 (GNA11) are early events in UM tumorigenesis. BRCA1 associated protein-1 (BAP1) is implicated in tumour progression and metastasis. (11) The cytogenetic profiles in UMs based on normal disomy 3, 6, 8, or partial/complete monosomy 3, 6p gain/loss, 6q gain/loss, 8p gain/loss, and 8p gain/loss have also been found to be predictive of the risk of melanoma-related metastasis. (12) Our study reports the clinical characteristics, treatment patterns and outcomes of patients with UM treated in a tertiary centre in Southeast Asia.
METHODSPatients with a diagnosis of UM made by clinical and/or pathologic analysis and who were followed up in our centre between 2002 and 2017 were retrospectively reviewed. Information on the patients' baseline demographics, clinical presentation, treatment and survival outcomes was collected. Approval from our Institutional Review Board was obtained.Choroidal melanoma (CM) was classified as small, medium or large based on the criteria established by the COMS. A melanoma INTRODUCTION We aimed to describe the clinical characteristics, diagnostic challenges, treatment patterns and outcomes of uveal melanoma (UM) in a tertiary care centre.METHODS This is a retrospective case series of 11 consecutive patients with UM who were managed in a tertiary referral centre between 2002 and 2017. Epidemiological, ...