Determining the risk of metastasis of choroidal melanoma: clinical and instrumental criteria

The purpose was to study the prevalence of metastasis of choroidal melanoma (CM) and clinical and instrumental criteria of the risk of such metastasis.

Material and methods. A detailed analysis of clinical material for the period of 2000–2018 is presented, involving 304 patients with CM under continuous observation by an ophthalmic oncology center of a multidisciplinary cancer institution.

Results. Metastatic lesion of various organs was diagnosed in 66 (21.7 %) patients. The average age of patients at the time of metastatic lesion verification was 55.65 ± 13.4 years, with the number of women patients prevailing (36 patients out of 66, or 54.5 %). Liver metastases were found in 63.6 %, lungs metastases, 4.5 %, multiple metastases — 31.9 % of patients. With regular follow-up, the critical period for metastasis detection was between one to five years — 77.2 % of patients with metastatic lesions and 16.8 % of the total number of the treated patients. The average time of metastasis appearance after the liquidation treatment was 27.75 ± 22.06 months, in cases of organ preservation treatment it was 61.57 ± 50.32 months. A metastatic process was diagnosed predominantly in large (63.6 %) and medium (28.8 %) CM. The risk criteria for metastatic development in CM were found to be: male gender, pre-equatorial localization, fungoid shape, large tumor size, pigmented tumor, transudative retinal detachment, mixed histopathological tumor variant.

Conclusion. The established clinical and instrumental criteria of the risk of metastatic lesion in choroidal melanoma should be considered when planning follow-up monitoring of this group of patients. 

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