Small but Challenging Conjunctival Melanoma: New Insights, Paradigms and Future Perspectives

Although its incidence has increased over the last decades, conjunctival melanoma (CM) remains a rare but challenging periocular malignancy. While there is currently no recognized standard of care, “no-touch” surgical excision followed by adjuvant treatments is usually recommended. Despite its small...

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Autores principales:	Sacha Nahon-Estève, Corine Bertolotto, Alexandra Picard-Gauci, Lauris Gastaud, Stéphanie Baillif, Paul Hofman, Anaïs Groulier, Célia Maschi, Jean-Pierre Caujolle, Sandra Lassalle, Arnaud Martel
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	conjunctival melanoma tumour recurrence metastases orbital exenteration targeted therapies immunotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/d95284d8d8e44be49e5a4fe9be36d73e
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spelling	oai:doaj.org-article:d95284d8d8e44be49e5a4fe9be36d73e2021-11-25T17:02:43ZSmall but Challenging Conjunctival Melanoma: New Insights, Paradigms and Future Perspectives10.3390/cancers132256912072-6694https://doaj.org/article/d95284d8d8e44be49e5a4fe9be36d73e2021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5691https://doaj.org/toc/2072-6694Although its incidence has increased over the last decades, conjunctival melanoma (CM) remains a rare but challenging periocular malignancy. While there is currently no recognized standard of care, “no-touch” surgical excision followed by adjuvant treatments is usually recommended. Despite its small size, managing CM is challenging for clinicians. The first challenge is the high risk of tumour local recurrence that occurs in about one third of the patients. The management of locally advanced CM (≥T2) or multiple recurrences may require mutilating surgeries such as orbital exenteration (OE). The second challenge is the metastatic spread of CM that occurs in about one quarter of patients, regardless of whether complete surgical excision is performed or not. This highlights the infiltrative and highly aggressive behaviour of CM. Recently, attention has been directed towards the use of eye-sparing strategies to avoid OE. Initially, wide conservative surgeries followed by customized brachytherapy or radiotherapy have appeared as viable strategies. Nowadays, new biological insights into CM have revealed similarities with cutaneous melanoma. These new findings have allowed clinicians to reconsider the management of locally advanced CM with “medical” eye-sparing treatment as well as the management of metastatic spread. The aim of this review was to summarize the current and future perspectives of treatment for CM based on recent biological findings.Sacha Nahon-EstèveCorine BertolottoAlexandra Picard-GauciLauris GastaudStéphanie BaillifPaul HofmanAnaïs GroulierCélia MaschiJean-Pierre CaujolleSandra LassalleArnaud MartelMDPI AGarticleconjunctival melanomatumour recurrencemetastasesorbital exenterationtargeted therapiesimmunotherapyNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5691, p 5691 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	conjunctival melanoma tumour recurrence metastases orbital exenteration targeted therapies immunotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	conjunctival melanoma tumour recurrence metastases orbital exenteration targeted therapies immunotherapy Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Sacha Nahon-Estève Corine Bertolotto Alexandra Picard-Gauci Lauris Gastaud Stéphanie Baillif Paul Hofman Anaïs Groulier Célia Maschi Jean-Pierre Caujolle Sandra Lassalle Arnaud Martel Small but Challenging Conjunctival Melanoma: New Insights, Paradigms and Future Perspectives
description	Although its incidence has increased over the last decades, conjunctival melanoma (CM) remains a rare but challenging periocular malignancy. While there is currently no recognized standard of care, “no-touch” surgical excision followed by adjuvant treatments is usually recommended. Despite its small size, managing CM is challenging for clinicians. The first challenge is the high risk of tumour local recurrence that occurs in about one third of the patients. The management of locally advanced CM (≥T2) or multiple recurrences may require mutilating surgeries such as orbital exenteration (OE). The second challenge is the metastatic spread of CM that occurs in about one quarter of patients, regardless of whether complete surgical excision is performed or not. This highlights the infiltrative and highly aggressive behaviour of CM. Recently, attention has been directed towards the use of eye-sparing strategies to avoid OE. Initially, wide conservative surgeries followed by customized brachytherapy or radiotherapy have appeared as viable strategies. Nowadays, new biological insights into CM have revealed similarities with cutaneous melanoma. These new findings have allowed clinicians to reconsider the management of locally advanced CM with “medical” eye-sparing treatment as well as the management of metastatic spread. The aim of this review was to summarize the current and future perspectives of treatment for CM based on recent biological findings.
format	article
author	Sacha Nahon-Estève Corine Bertolotto Alexandra Picard-Gauci Lauris Gastaud Stéphanie Baillif Paul Hofman Anaïs Groulier Célia Maschi Jean-Pierre Caujolle Sandra Lassalle Arnaud Martel
author_facet	Sacha Nahon-Estève Corine Bertolotto Alexandra Picard-Gauci Lauris Gastaud Stéphanie Baillif Paul Hofman Anaïs Groulier Célia Maschi Jean-Pierre Caujolle Sandra Lassalle Arnaud Martel
author_sort	Sacha Nahon-Estève
title	Small but Challenging Conjunctival Melanoma: New Insights, Paradigms and Future Perspectives
title_short	Small but Challenging Conjunctival Melanoma: New Insights, Paradigms and Future Perspectives
title_full	Small but Challenging Conjunctival Melanoma: New Insights, Paradigms and Future Perspectives
title_fullStr	Small but Challenging Conjunctival Melanoma: New Insights, Paradigms and Future Perspectives
title_full_unstemmed	Small but Challenging Conjunctival Melanoma: New Insights, Paradigms and Future Perspectives
title_sort	small but challenging conjunctival melanoma: new insights, paradigms and future perspectives
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/d95284d8d8e44be49e5a4fe9be36d73e
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Small but Challenging Conjunctival Melanoma: New Insights, Paradigms and Future Perspectives

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