Is observation really appropriate for small choroidal melanomas.
Many, if not most, patients with a suspected small choroidal melanoma are currently managed by observation until tumor enlargement is documented. Current evidence appears to be insufficient to determine the correctness of this approach. A randomized clinical trial that could resolve this issue is probably not feasible. In the absence of satisfactory evidence, the decision about how to manage such patients depends on a subjective benefit-risk analysis that takes into account two competing but indeterminate risks: the risk of inadequate treatment for those patients who have a true melanoma and the risk of excessive treatment for those who have a benign nevus. Technologic advances and development of effective treatment for metastatic disease may eliminate most of the concern that currently accompanies observation as management for such tumors in the future.
Augsburger
J J
JJ
Oncology Unit, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia.
D002830:Choroid Neoplasms / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008545:Melanoma / Q000473:pathology* / Q000628:therapy