Choriodal melanoma: is enucleation still relevant?

For many centuries, enucleation was the only method of treating Choriodal melanoma CM, and, despite the development of many organ-preserving methods, it has not lost it’s relevance today. In recent years, microRNAs, which began to receive attention from the beginning of the 2000s, now play the role of biological markers in many diseases both in diagnosis and in assessing the effectiveness of treatment. There are only a few studies on the significance of circulating microRNAs as a marker of the effectiveness of surgical treatment of cancers of certain locations (breast, lungs). As for uveal melanoma, there is practically no such information in the literature.

The purpose of the work is to determine the effectiveness of enucleation as a surgical method for treating large choroids, based on the nature of the expression of microRNA-223, microRNA-27b, microRNA-155 in the blood plasma of patients in M0N0 stage.

Material and methods. 83 patients with CM aged 61.5 ± 10.9 years (22–83 years) were examined. The thickness of the MC varied from 2.23 to 22.00 mm (on average 9.32 ± 3.97 mm). The control group consisted of 28 volunteers aged 45–78 years (average 62.90 ± 1.42 years). The expression pattern of microRNA-223, microRNA-27, microRNA-155 in the blood plasma of patients was determined by quantitative polymerase chain reaction before and over a period of 3 to 54 months after surgery.

Results. In all patients the expression pattern showed overexpression of all microRNAs compared to the control group at different periods of the study, starting from 3 months. During observation, 6 patients were diagnosed with liver metastases. A comparison of the study results in this group before and after enucleation with a group of patients without metastases showed an increase in the expression of a panel of microRNAs during the development of metastases.

Conclusion. Enucleation remains the operation of choice in patients with large choroidal melanomas at the M0N0 stage. Control of the nature of the expression of microRNA-223, microRNA-27b and microRNA-155 in the blood plasma of patients makes it possible to personalize the indications for enucleation.

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