ABSTRACT NUMBER - 303

UVEAL MELANOMA: A REVIEW OF THE EVIDENCE ON SURVEILLANCE AND SURVIVAL IN METASTATIC DISEASE


James Sax1, Thomas Campbell4, Todd Goodwin3, Sunil Warrier2, William Glasson2

Meeting:  2016 RANZCO


A recent paper investigating the surveillance and treatment of uveal melanoma (UM) by Piperno-Neumann, et al. (2015) suggests that a paradigm shift away from palliation and toward active surveillance and treatment of early metastatic disease is needed. The purpose of this study was to review the available literature on survival and metastatic screening for UM firstly to further quantify the survival benefit suggested by Piperno-Neumann and colleagues, and secondly to identify the optimal mode of surveillance for metastatic disease.

Method: A comprehensive electronic review of the literature was undertaken, with 37 papers identified that met search criteria. Two independent reviews of these papers were done to assess data fulfilling primary and secondary outcome measures. Primary measures were time from diagnosis of UM to death and time from diagnosis to identification of metastasis. Secondary measures were number and size of metastatic lesions detected.

While early detection and treatment of uveal melanoma would ideally demonstrate a clear survival advantage, supporting regular surveillance for metastatic disease in uveal melanoma, this study highlighted the complexity of interpreting screening tests in the context of lead time bias in disease detection, and limitations of interventions available in improving survival following early detection of metastatic disease.