SURGICAL APPROACH IN THE TREATMENT OF CONJUNCTIVE MELANOMA

Abstract

Conjunctival melanoma is a rare and aggressive type of eye cancer that originates in the pigment-producing cells of the conjunctiva. Surgical approach is often the main treatment modality, aiming for complete removal of the tumor with free margins to minimize the risk of recurrence and metastasis. Surgery can be combined with adjuvant therapies, such as topical chemotherapy and radiotherapy, to improve clinical outcomes. Early identification and appropriate treatment are crucial to increasing survival rates and reducing the morbidity associated with this condition. Objective: The objective of this systematic literature review was to compile and critically analyze the available evidence on the effectiveness and safety of surgical approaches in the treatment of conjunctival melanoma, focusing on studies published in the last 10 years. Methodology: The methodology followed the PRISMA checklist, using the PubMed, Scielo and Web of Science databases. The descriptors used were “conjunctival melanoma”, “surgical treatment”, “recurrence”, “metastasis” and “survival”. The inclusion criteria were: studies published in English or Portuguese, studies that addressed surgery as the main treatment for conjunctiva melanoma and studies with data on clinical results. Exclusion criteria included: studies that did not focus on the surgical approach, studies with samples smaller than 10 patients and literature reviews without primary data analysis. Results: The results showed that surgical excision with free margins was effective in reducing local recurrence of conjunctival melanoma. Combination with adjuvant therapies, such as topical chemotherapy with mitomycin C and radiotherapy, has significantly improved disease-free survival rates. However, the rate of metastasis remained a challenge, especially in cases with scleral or eyelid involvement. Detailed histopathological analysis and close follow-up were essential for adequate patient management. Conclusion: The surgical approach in the treatment of conjunctiva melanoma proved to be effective in reducing local recurrence and improving survival rates when combined with adjuvant therapies. Early identification and appropriate treatment are essential for a positive prognosis. Future studies should focus on strategies to reduce the rate of metastasis and further improve clinical outcomes for patients with conjunctival melanoma.