title: Management of uveal melanoma: a consensus-based provincial clinical practice guideline.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB;; Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB;
authors.forename: E
authors.initials: E
authors.lastname: Weis
authors.affiliation: Division of Dermatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB;
authors.forename: T G
authors.initials: TG
authors.lastname: Salopek
authors.affiliation: Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB;; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB;
authors.forename: J G
authors.initials: JG
authors.lastname: McKinnon
authors.affiliation: Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB;
authors.forename: M P
authors.initials: MP
authors.lastname: Larocque
authors.affiliation: Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB;; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB;
authors.forename: C
authors.initials: C
authors.lastname: Temple-Oberle
authors.affiliation: Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB;
authors.forename: T
authors.initials: T
authors.lastname: Cheng
authors.affiliation: Department of Surgery, Cumming School of Medicine, University of Calgary, Calgary, AB;; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB;
authors.forename: J
authors.initials: J
authors.lastname: McWhae
authors.affiliation: Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB;
authors.forename: R
authors.initials: R
authors.lastname: Sloboda
authors.affiliation: Cancer Strategic Clinical Network, Alberta Health Services, Calgary, AB.
authors.forename: M
authors.initials: M
authors.lastname: Shea-Budgell
keywords: Uveal melanoma; choroidal melanoma; ciliary body melanoma; iris melanoma; melanoma; ocular melanoma; ophthalmology; practice guidelines