[Antitumor immunity in patients with melanoma of the uveal tract]

Over the years 1977-1987 142 patients with malignant melanoma of the uvea were admitted to the Department of Ophthalmology, Teaching Hospital, Comenius University in Bratislava. Of the 119 patients treated by enucleation of the bulb 74.8% were alive after a mean follow up period of 5.9 years, whereas 25.2% of these patients died of consequences of metastases of the melanoma of the eye. The highest death rate was recorded in the first and second year following enucleation (57%) and then in the fourth year (17%). After the eighth year following enucleation of the bulb not a single case of death from consequences of metastases of melanoma was recorded. Eight patients with localization of the tumor in the anterior part of the uveal tract (iris, ciliary body) were treated by microsurgical removal of the tumor from the bulb. Two patients developed relapse of the tumor and the eyeballs had to be enucleated. After a mean follow up period of 6.6 years all these patients are alive and so far no signs of metastases have been observed. Moreover, the visual acuity has remained good in the patients whose eyes were not enucleated. Electrocoagulation was applied in six patients. Within a year the eyes had to be enucleated in three of them due to tumor progression. In two patients the growth of the tumor seems to have been stopped, yet regression of the tumor has not been observed. Complete healing was recorded only in one patient. After a mean follow up period of 4.5 years all the patients are alive without signs of metastases. A series of eight patients refused any kind of treatment of melanoma. Over a follow up period of 8.5 years six of them (75%) died of consequences of metastases within an average of 3.2 years from the establishment of diagnosis. Although the majority of these cases had small and middle sized melanomas, at present only two patients (25%) are still alive. In 127 patients with histologically proved malignant melanoma of the uvea the LAI test for the determination of uveal tumor antigen was also performed. The test was positive in 78.7% of the patients and negative in 23.3%. In a control group of patients with nontumorous eye diseases the LAI test was positive only in 2.9% and negative in 91.1%. Four months after enucleation of the bulb the LAI test was repeated and positivity was found to persist in 57.8% of the patients.(ABSTRACT TRUNCATED AT 400 WORDS)