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Uveal melanoma: Treatment approaches and prognostic outcomes based on the American joint committee on cancer staging
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DOI：10.1016/j.apjo.2026.100295.png)
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Abstract
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Purpose: To evaluate the clinical characteristics, treatment outcomes, and prognosis of uveal melanoma (UM) based on the 8th edition of the American Joint Committee on Cancer (AJCC) staging system. Design: Retrospective study. Methods: Data on the clinical presentation, diagnostic methods, treatment approaches, and long-term outcomes of patients diagnosed with UM at a tertiary referral center in Thailand between 2010 and 2024 were included and analyzed. Results: Of 106 patients included, the mean (range) age at diagnosis was 51.6 (16-86) years. The most common tumor location was the choroid (n = 100, 94.3%), followed by the ciliary body (n = 4, 3.8%) and iris (n = 2, 1.9%). AJCC tumor staging was T1 in 18.9%, T2 in 17.9%, T3 in 48.1%, and T4 in 15.1% of cases. Primary treatment included enucleation (n = 57, 53.8%), Ruthenium-106 (106Ru) brachytherapy (n = 31, 29.2%), endoresection combined with 106 Ru brachytherapy (n = 17, 16.0%), and exoresection (n = 1, 0.9%). At a median follow-up of 37.3 months, the overall globe salvage rate was 44.3%. Kaplan-Meier analysis showed a 5year and 10-year distant metastasis rate of 22%, with disease-specific survival rates of 82% and 75%, respectively. The incidence of melanoma-related death was 3.4 per 100 person-years, increasing with tumor stage. In multivariate analysis, distant metastasis was the only significant factor associated with the overall survival outcome. Conclusions: This study provides insights into the clinical features, treatment outcomes, and prognostic factors of UM in a Southeast Asian cohort. Tumor stage and the presence of metastasis significantly influence prognosis, highlighting the importance of early detection and individualized treatment strategies to improve patient outcomes.
Keywords:
Clinical cancer research
Melanoma
Prognosis
Radiation therapy
Risk assessment
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