A study led by UCLA has found that a surgical method designed to protect vision in patients with uveal melanoma, a rare cancer of the eye, may also reduce the risk of the disease spreading and improve patient survival. The research, published in the journal Cancers, observed 37 patients who were treated for uveal melanoma. Most underwent targeted radiation therapy called plaque brachytherapy along with a procedure that replaces the eye’s gel-like interior with silicone oil. This technique is intended to shield healthy parts of the eye from radiation while allowing the tumor to receive an effective dose.
After a median follow-up period of more than four years, over 80% of participants remained free from metastatic disease, and none experienced recurrence in the treated eye. Six patients (16%) developed metastases, and one died as a result of the cancer. Historically, about 30% of uveal melanoma patients develop metastases—often in the liver—with few surviving beyond five years.
“Everything about uveal melanoma has always been painted with limited hope, with patients expected to lose vision and eventually die once the cancer spreads,” said , director of the , an investigator in the , and senior author of the study. “We know that this unique surgical technique clearly saves vision. However, we did not expect the technique to alter metastasis and mortality. And anything that improves survival in uveal melanoma is a game-changer.”
The method was first introduced at UCLA over ten years ago and had previously shown promise in reducing radiation-related vision loss. Interest in its impact on metastasis grew when Dr. Wolfram Samlowski, who monitors patients for metastasis in Las Vegas, noted unexpectedly low rates among those treated with this approach.
Researchers analyzed clinical outcomes and genetic risk factors among 37 patients: 27 received plaque brachytherapy with vitrectomy and silicone oil placement; seven received only brachytherapy; three had their eyes removed. Patients were categorized into high- or low-risk groups based on tumor genetics. They found even high-risk individuals had lower-than-expected rates of metastasis and death.
Tumor size and stage did not reliably predict whether cancer would spread within this group—some with small tumors developed metastases while many with larger tumors did not. Genetic tests proved effective at identifying those at low risk but less so for high-risk prediction due to overall low progression rates observed.
“Our study shows that combining plaque brachytherapy with vitrectomy and silicone oil not only helps patients preserve their vision but may also improve survival,” McCannel said. “Since most centers still rely on plaque brachytherapy alone to treat uveal melanoma, these findings underscore the need to adopt our vitrectomy with silicone oil approach.”
Researchers cautioned that further studies are necessary to determine whether improved outcomes are due to surgical techniques, radiation delivery methods, or other factors. They also highlighted a need for more training among ocular oncologists in performing retinal surgery required for silicone oil placement.
Other authors on this study include Axel Rivas from University of Nevada and Dr. Wolfram Samlowski from Nevada Oncology Specialists.
