Management of uveal melanoma: a consensus-based provincial clinical practice guideline

E. Weis, T.G. Salopek, J.G. McKinnon, M.P. Larocque, C. Temple-Oberle, T. Cheng, J. McWhae, R. Sloboda, M. Shea-Budgell

Abstract


Introduction

Survival in uveal melanoma has remained unchanged since the early 1970s. Because outcomes are highly related to the size of the tumour, timely and accurate diagnosis can increase the chance for cure.

Methods

A consensus-based guideline was developed to inform practitioners. PubMed was searched for publications related to this topic. Reference lists of key publications were hand-searched. The National Guidelines Clearinghouse and individual guideline organizations were searched for relevant guidelines. Consensus discussions by a group of content experts from medical, radiation, and surgical oncology were used to formulate the recommendations.

Results

Eighty-four publications, including five existing guidelines, formed the evidence base.

Summary

Key recommendations highlight that, for uveal melanoma and its indeterminate melanocytic lesions in the uveal tract, management is complex and requires experienced specialists with training in ophthalmologic oncology. Staging examinations include serum and radiologic investigations. Large lesions are still most often treated with enucleation, and yet radiotherapy is the most common treatment for tumours that qualify. Adjuvant therapy has yet to demonstrate efficacy in reducing the risk of metastasis, and no systemic therapy clearly improves outcomes in metastatic disease. Where available, enrolment in clinical trials is encouraged for patients with metastatic disease. Highly selected patients might benefit from surgical resection of liver metastases.


Keywords


Uveal melanoma; ocular melanoma; choroidal melanoma; ciliary body melanoma; iris melanoma; melanoma; ophthalmology; practice guidelines

Full Text:

PDF HTML


DOI: http://dx.doi.org/10.3747/co.23.2859






Copyright © 2019 Multimed Inc.
ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)