Uveal melanoma is the most common primary malignant
tumor of the eye in adults, predominantly found in Caucasians. Local
tumor control of
uveal melanoma is excellent, yet this
malignancy is associated with relatively high mortality secondary to
metastasis. Various clinical, histopathological, cytogenetic features and gene expression features help in estimating the prognosis of
uveal melanoma. The clinical features associated with poor prognosis in patients with
uveal melanoma include older age at presentation, male gender, larger
tumor basal diameter and thickness, ciliary body location, diffuse
tumor configuration, association with ocular/oculodermal melanocytosis, extraocular
tumor extension, and advanced
tumor staging by American Joint Committee on
Cancer classification. Histopathological features suggestive of poor prognosis include epithelioid cell type, high mitotic activity, higher values of mean diameter of ten largest nucleoli, higher microvascular density, extravascular matrix patterns, tumor-infiltrating lymphocytes,
tumor-infiltrating macrophages, higher expression of
insulin-like growth factor-1 receptor, and higher expression of
human leukocyte antigen Class I and II.
Monosomy 3, 1p loss, 6q loss, and 8q and those classified as Class II by gene expression are predictive of poor prognosis of
uveal melanoma. In this review, we discuss the prognostic factors of
uveal melanoma. A database search was performed on PubMed, using the terms "uvea," "iris," "ciliary body," "choroid," "
melanoma," "uveal melanoma" and "prognosis," "
metastasis," "genetic testing," "gene expression profiling." Relevant English language articles were extracted, reviewed, and referenced appropriately.