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

  • E. Weis University of Alberta; University of Calgary
  • T.G. Salopek University of Calgary
  • J.G. McKinnon University of Calgary
  • M.P. Larocque University of Alberta
  • C. Temple-Oberle University of Calgary
  • T. Cheng University of Calgary
  • J. McWhae University of Calgary
  • R. Sloboda University of Alberta
  • M. Shea-Budgell University of Calgary; Alberta Health Services
Keywords: Uveal melanoma, ocular melanoma, choroidal melanoma, ciliary body melanoma, iris melanoma, melanoma, ophthalmology, practice guidelines

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.

Author Biographies

E. Weis, University of Alberta; University of Calgary
Department of Ophthalmology and Visual Sciences, Faculty of Medicine and Dentistry; Department of Surgery, Cumming School of Medicine
T.G. Salopek, University of Calgary
Department of Surgery, Cumming School of Medicine
J.G. McKinnon, University of Calgary
Department of Surgery and Department of Oncology , Cumming School of Medicine
M.P. Larocque, University of Alberta
Department of Oncology, Faculty of Medicine and Dentistry
C. Temple-Oberle, University of Calgary
Department of Surgery and Department of Oncology, Cumming School of Medicine,
T. Cheng, University of Calgary
Department of Oncology, Cumming School of Medicine
J. McWhae, University of Calgary
Department of Surgery and Department of Oncology, Cumming School of Medicine,
R. Sloboda, University of Alberta
Department of Oncology, Faculty of Medicine and Dentistry
M. Shea-Budgell, University of Calgary; Alberta Health Services
Department of Oncology, Cumming School of Medicine; Cancer Strategic Clinical Network
Published
2015-11-20
How to Cite
Weis, E., Salopek, T., McKinnon, J., Larocque, M., Temple-Oberle, C., Cheng, T., McWhae, J., Sloboda, R., & Shea-Budgell, M. (2015). Management of uveal melanoma: a consensus-based provincial clinical practice guideline. Current Oncology, 23(1), e57-e64. https://doi.org/10.3747/co.23.2859
Section
Practice Guideline