Features of uveal melanoma clinical course

Purpose of the study. Analysis of the clinical characteristics of patients with uveal melanoma to determine the features of the disease course.
Patients and methods. The study included 223 patients with a diagnosis of uveal melanoma who were examined at the NMRC for Oncology, the Russian Federation Ministry of Health, in the period from 2019 to 2024. All patients underwent a standard ophthalmological examination, and computed tomography of the orbits, chest, and abdominal organs was performed. Using the methods of standard descriptive statistics, patient data were analyzed in order to identify the ratio of the following: gender, age, location of the neoplasm and its size, the degree of spread of the primary tumor, metastasis and clinical symptoms.
Results. In the study group, the number of male patients was 92 people (41.2 %) and female patients – 131 people (58.8 %). The average age of all patients was 61.3 ± 0.9 years. The incidence among female patients is higher than among male patients, especially at the age of 60 to 74 years. The most common localization of uveal melanoma is the choroid, which accounted for 85.6 % (191 patients). Tumors with degree of spread of T2 and T3 were predominant – 70 (31.4 %) and 76 (34.1 %) people, respectively. Medium and large tumors were diagnosed in a larger number of patients – 30.9 % and 40.4 %, respectively. Among all patients, distant metastases were detected in 11.6 %. The main site of metastasis is the liver (61 %). To a lesser extent, metastatic lesions were found in the lungs and bones (9–13 %), as well as the kidneys, adrenal glands, pancreas and brain (3–7 %). A wide range of symptoms and consequences of the spread of the primary tumor was revealed.
Conclusion. The variety of clinical symptoms in uveal melanoma depends on the location and extent of the tumor. Understanding the features of the development of the disease and its manifestations contributes to timely diagnosis and effective treatment.

1. Maheshwari A, Finger PT. Cancers of the eye. Cancer Metastasis Rev. 2018 Dec;37(4):677–690. https://doi.org/10.1007/s10555‑018‑9762‑9

2. Bray F, Colombet M, Mery L, Piñeros M, Znaor A, Zanetti R, Ferlay J. Cancer incidence in five continents Vol. XI. International Agency for Research on Cancer. 2022.

3. Virgili G, Gatta G, Ciccolallo L, Capocaccia R, Biggeri A, Crocetti E, et al.; EUROCARE Working Group. Incidence of uveal melanoma in Europe. Ophthalmology. 2007 Dec;114(12):2309–2315. https://doi.org/10.1016/j.ophtha.2007.01.032

4. Kit OI, Frantsiyants EM, Bandovkina VA, Kaplieva IV, Surikova EI, Trepitaki LK, et al. Does change in neurotransmitter brain status affect the growth of transplantable melanoma? Bulletin of Siberian Medicine. 2020;19(4):94–101. (In Russ.). https://doi.org/10.20538/1682‑0363‑2020‑4‑94‑101

5. McLaughlin CC, Wu XC, Jemal A, Martin HJ, Roche LM, Chen VW. Incidence of noncutaneous melanomas in the U.S. Cancer. 2005 Mar 1;103(5):1000–1007. https://doi.org/10.1002/cncr.20866

6. Kaliki S, Shields CL. Uveal melanoma: relatively rare but deadly cancer. Eye (Lond). 2017 Feb;31(2):241–257. https://doi.org/10.1038/eye.2016.275

7. Ortega MA, Fraile‑Martínez O, García‑Honduvilla N, Coca S, Álvarez‑Mon M, Buján J, Teus MA. Update on uveal melanoma: Translational research from biology to clinical practice (Review). Int J Oncol. 2020 Dec;57(6):1262–1279. https://doi.org/10.3892/ijo.2020.5140

8. Yarovoy AA, Demidov LV, Levashov IA, Nazarova VV, Yarovaya VA. Cutaneous and uveal melanoma: similarities and differences. Effective Pharmacotherapy. 2020;16(18):78–85. (In Russ.).

9. Gevorkyan YuA, Soldatkina NV, Bondarenko OK, Mironenko IN, Kolesnikov VE, Dashkov AV. Clinical observation of patients with primary multiple malignant tumors, including primary multiple melanoma. South Russian Journal of Cancer. 2023;4(3):51–55. https://doi.org/10.37748/2686‑9039‑2023‑4‑3‑6

10. Kaliki S, Shields CL, Shields JA. Uveal melanoma: estimating prognosis. Indian J Ophthalmol. 2015 Feb;63(2):93–102. https://doi.org/10.4103/0301‑4738.154367

11. Saakian SV, Amirian AG, Tsygankov AIu. Clinical course and vital prognosis for uveal melanoma in young patients. Russian Annals of Ophthalmology. 2013;129(6):4–9. (In Russ.).

12. Singh AD, Schoenfield LA, Bastian BC, Aziz HA, Marino MJ, Biscotti CV. Congenital uveal melanoma? Surv Ophthalmol. 2016 Jan‑ Feb;61(1):59–64. https://doi.org/10.1016/j.survophthal.2015.07.005

13. Yarovoy AA, Alekseev AS, Volodin DP, Matyaeva AD, Yarovaya VA. Uveal melanoma in children and adolescents: clinical features and treatment approaches according to 30‑years’ experience. Russian Journal of Pediatric Hematology and Oncology 2025;12(1):20–26. (In Russ.). https://doi.org/10.21682/2311‑1267‑2025‑12‑1‑20‑26

14. Wu SN, Qin DY, Zhu L, Guo SJ, Li X, Huang CH, et al. Uveal melanoma distant metastasis prediction system: A retrospective observational study based on machine learning. Cancer Sci. 2024 Sep;115(9):3107–3126. https://doi.org/10.1111/cas.16276

15. Jager MJ, Shields CL, Cebulla CM, Abdel‑Rahman MH, Grossniklaus HE, Stern MH, et al. Uveal melanoma. Nat Rev Dis Primers. 2020 Apr 9;6(1):24. https://doi.org/10.1038/s41572‑020‑0158‑0 Erratum in: Nat Rev Dis Primers. 2022 Jan 17;8(1):4. https://doi.org/10.1038/s41572‑022‑00339‑9

16. Uveal melanoma. Clinical guidelines. Association of Ophthalmologists, Association of Oncologists of Russia, Association of Melanoma Specialists, All‑Russian public organization "Society of Ophthalmologists of Russia". Moscow, 2020. (In Russ.).

17. Liu YM, Li Y, Wei WB, Xu X, Jonas JB. Clinical Characteristics of 582 Patients with Uveal Melanoma in China. PLoS One. 2015 Dec 8;10(12):e0144562. https://doi.org/10.1371/journal.pone.0144562

18. Sakamoto T, Sakamoto M, Yoshikawa H, Hata Y, Ishibashi T, Ohnishi Y, Inomata H. Histologic findings and prognosis of uveal malignant melanoma in japanese patients. Am J Ophthalmol. 1996 Mar;121(3):276–283. https://doi.org/10.1016/s0002‑9394(14)70275‑2

19. Al‑Jamal RT, Kivelä T. Uveal melanoma among Finnish children and young adults. J AAPOS. 2014 Feb;18(1):61–66. https://doi.org/10.1016/j.jaapos.2013.11.006

20. Grishina EE, Lerner MYu, Gemdzhian EG. Epidemiology of uveal melanomas in Moscow. Almanac of Clinical Medicine. 2017;45(4):321– 325. (In Russ.). https://doi.org/10.18786/2072‑0505‑2017‑45‑4‑321‑325

21. Kim JH, Shin SJ, Heo SJ, Choe EA, Kim CG, Jung M, et al. Prognoses and Clinical Outcomes of Primary and Recurrent Uveal Melanoma. Cancer Res Treat. 2018 Oct;50(4):1238–1251. https://doi.org/10.4143/crt.2017.534

22. Shields CL, Furuta M, Thangappan A, Nagori S, Mashayekhi A, Lally DR, et al. Metastasis of uveal melanoma millimeter‑by‑millimeter in 8033 consecutive eyes. Arch Ophthalmol. 2009 Aug;127(8):989–998. https://doi.org/10.1001/archophthalmol.2009.208

23. Amaro A, Gangemi R, Piaggio F, Angelini G, Barisione G, Ferrini S, Pfeffer U. The biology of uveal melanoma. Cancer Metastasis Rev. 2017 Mar;36(1):109–140. https://doi.org/10.1007/s10555‑017‑9663‑3

24. AJCC Ophthalmic Oncology Task Force. International Validation of the American Joint Committee on Cancer's 7th Edition Classification of Uveal Melanoma. JAMA Ophthalmol. 2015 Apr;133(4):376–383. https://doi.org/10.1001/jamaophthalmol.2014.5395 Erratum in: JAMA Ophthalmol. 2015 Apr;133(4):493. https://doi.org/10.1001/jamaophthalmol.2015.0858 Erratum in: JAMA Ophthalmol. 2015 Sep;133(9):1096. https://doi.org/10.1001/jamaophthalmol.2015.2843

25. Coupland SE, Campbell I, Damato B. Routes of extraocular extension of uveal melanoma: risk factors and influence on survival probability. Ophthalmology. 2008 Oct;115(10):1778–1785. https://doi.org/10.1016/j.ophtha.2008.04.025

26. Amiryan AH, Panpherova OV, Saakyan SV. Inadequate management of patients with uveal melanoma (analysis of three clinical cases). Head and Neck. 2021;9(3):67–71. (In Russ.). https://doi.org/10.25792/hn.2021.9.3.67‑71

27. Yuan Y, Jiang YC, Sun CK, Chen QM. Role of the tumor microenvironment in tumor progression and the clinical applications (Review). Oncol Rep. 2016 May;35(5):2499–2515. https://doi.org/10.3892/or.2016.4660

28. Vinay DS, Ryan EP, Pawelec G, Talib WH, Stagg J, Elkord E, et al. Immune evasion in cancer: Mechanistic basis and therapeutic strategies. Semin Cancer Biol. 2015 Dec;35 Suppl:S185–S198. https://doi.org/10.1016/j.semcancer.2015.03.004