Micrometastatic Dormancy in Uveal Melanoma: A Comprehensive Review of the Evidence, Mechanisms, and Implications for Future Adjuvant Therapies.
Micrometastatic Dormancy in Uveal Melanoma: A Comprehensive Review of the Evidence, Mechanisms, and Implications for Future Adjuvant Therapies.
复制标题
葡萄膜黑色素瘤的微转移休眠：对未来辅助治疗的证据、机制和影响的全面回顾。
DOI：
10.1097/iio.0000000000000160
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发表时间：
2017
影响因子：
--
通讯作者：
Daniels,AnthonyB
中科院分区：
文献类型：
--
作者：
Nichols,ErinE;Richmond,Ann;Daniels,AnthonyB
Uveal melanoma is the most common intraocular malignancy in adults, arising from melanocytes within the iris, ciliary body, and choroid. 1–3 In recent decades, the annual incidence of uveal melanoma has remained stable, estimated at 6 to 7 cases per million. 1–3 Although major, morbidity-limiting advances have been made in eye-preserving local tumor control, the 5-year survival rate has remained unchanged, hovering between 72% and 84%. 4–7 Despite effective local tumor control with radioactive plaque brachytherapy, external or charged particle radiation, or enucleation, as many as 50% of patients ultimately develop metastases. Metastatic spread is hematogenous and involves the liver in> 90% of patients. 3, 8Strikingly, the development of overt metastases can occur> 15 years following the initial diagnosis of uveal melanoma. 3, 5, 6, 9 In fact, long-term follow-up data revealed that the number one cause of death in these patients remained metastatic uveal melanoma. This was true for> 20 years following the initial ocular diagnosis, despite the fact that uveal melanoma predominantly arises in the elderly who often have numerous other comorbidities. 9 Patients with clinically apparent uveal melanoma metastases live on average< 6 months following diagnosis. 3, 5, 10 This implies that these patients who died of metastatic uveal melanoma 20 years after initial ocular diagnosis usually did not have overt metastatic disease for the preceding 19 years.
