Scottish Ocular Oncology Service, Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow, UK.
Department of Radiology, Gartnavel General Hospital, Glasgow, UK.
Eye (Lond). 2023 Apr;37(5):894-899. doi: 10.1038/s41433-022-02198-w. Epub 2022 Aug 9.
Ophthalmic treatments are successful in managing uveal melanomas achieving good local control. However, a large number still metastasise, primarily to the liver, resulting in mortality. There is no consensus across the world on the mode, frequency, duration or utility of regular liver surveillance for metastasis and there are no published protocols. The Scottish Ocular Oncology Service (SOOS) constituted a Scottish Consensus Statement Group (SCSG) which included ocular oncologists, medical oncologists, radiologists and a uveal melanoma patient as a lay member. This group carried out an extensive review of literature followed by discussions to arrive at a consensus regarding surveillance planning for posterior uveal melanoma patients in Scotland. The Consensus Statement would provide a framework to guide each patient's surveillance plan and provide all patients with clarity and transparency on the issue. The SCSG was unable to find adequate evidence on which to base the strategy. The consensus statement recommends a risk-stratified approach to surveillance for these patients dividing them into low to medium-risk and high-risk groups defining the mode and duration of surveillance for each. It supplements the UK-wide Uveal Melanoma National Guidelines and allows a more uniform consensus-based approach to surveillance in Scotland. It has been adopted nationally by all health care providers in Scotland as a guideline and is available to patients on a publicly accessible website.
眼部治疗在控制葡萄膜黑色素瘤方面取得了成功,但仍有大量患者发生转移,主要转移到肝脏,导致死亡。全世界对于转移的定期肝脏监测的模式、频率、持续时间和实用性没有达成共识,也没有公布相关方案。苏格兰眼部肿瘤服务(SOOS)成立了一个苏格兰共识声明小组(SCSG),成员包括眼部肿瘤学家、肿瘤内科医生、放射科医生和一名葡萄膜黑色素瘤患者作为非专业成员。该小组对文献进行了广泛审查,然后进行了讨论,以就苏格兰后部葡萄膜黑色素瘤患者的监测计划达成共识。该共识声明将为每个患者的监测计划提供框架,并就该问题为所有患者提供明确性和透明度。SCSG 无法找到足够的证据来支持该策略。该共识声明建议对这些患者进行风险分层监测,将他们分为低到中风险和高风险组,为每个组定义监测的模式和持续时间。它补充了英国范围内的葡萄膜黑色素瘤国家指南,并允许在苏格兰采用更统一的基于共识的监测方法。它已被苏格兰所有医疗保健提供者采用为指南,并在一个公共可访问的网站上提供给患者。