Uveal melanoma (UM) is the most common intraocular malignant tumor, with an incidence of approximately six cases per million per year in the Caucasian population. It shows a high propensity (in 90% of cases) to metastasize to the liver. Its prognosis is poor, with a survival of approximately 50% at 10 to 15 years, despite successful treatment of the primary tumor.
1 Ophthalmologists and oncologists have recently considered the possibility of developing adjuvant systemic treatments for high-risk patients.
2 Such treatments imply that tumors associated with a high metastatic risk at time of diagnosis can be reliable detected, to identify eligible patients. Beside clinicopathologic features (tumor size, location, histology, and extrascleral invasion), certain genomic alterations of the tumor, affecting mainly chromosomes 3, 6, and 8, have been identified by karyotype analyses, then by fluorescence in situ hybridization (FISH) and comparative genomic hybridization (CGH) (for review, see Ref.
3 ). The status of chromosome 3 has been shown to be strongly associated with outcome. Monosomy 3 is an early event present in 50% to 60% of tumors, often associated with the long arm of isochromosome 8, and approximately 60% of patients having a monosomic 3 tumor experience a metastatic evolution, whereas disomic 3 tumors are thought only rarely to lead metastatic disease.
4 5 6 7 In addition, other recurrent chromosome alterations, such as imbalance of chromosome 6 and losses of 1p and 16q, have been described.
8 9 10 11 12 Today, genome-wide techniques of genomic and expression profiling make it possible to analyze these tumors with a much higher resolution and without the limitations of cytogenetic analyses. These approaches may improve the characterization of high-risk UM. Recently, with gene expression profiling, two distinct molecular classes strongly associated with metastatic risk have been identified.
13 14 15 In other cancers, DNA-based techniques are known to be robust methods of classifying tumors on the basis of genomic profile. In this study, we investigated the use of array CGH for refining the identification of regions of imbalance related to metastatic evolution in UM and for the search of genes involved in the development of this tumor. To date, only two pangenomic studies of array CGH, performed on 18 and 49 primary tumors, have been reported,
16 17 and little is known about the genomic profiles of uveal melanoma metastases.
10 We report the array CGH analysis of 86 primary tumors and, for the first time, of 66 liver metastases, in an attempt to identify a genomic profile associated with high-risk UM.