Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Sep 24.
doi: 10.1111/ceo.70002. Online ahead of print.

Systemic Surveillance Guidelines for Uveal Melanoma: A Systematic Review

Farzana Y Zaman  1 , Aisha Ghaus  1 , Mark Shackleton  1   2 , Damien Kee  3   4 , Anthony M Joshua  5   6 , Roderick O'Day  7 , Malaka Ameratunga  1   2
Affiliations

Systemic Surveillance Guidelines for Uveal Melanoma: A Systematic Review

Farzana Y Zaman et al. Clin Exp Ophthalmol. .

Abstract

Background: Uveal melanoma (UM) is the most common primary intraocular tumour. Despite effective local therapies, UM has a high risk of metastatic recurrence, most frequently to the liver. A significant proportion of patients treated definitively for primary UM eventually experience metastatic disease. Systemic surveillance to detect recurrence is critical to maximise therapeutic options. Whilst international guidelines exist, there are currently no standardised Australian guidelines for surveillance imaging. This systematic review examines the literature regarding systemic surveillance methods following local treatment for UM.

Methods: Medline, Embase and PubMed databases were searched, from 2010 to 01-07-2024, using keywords related to uveal melanoma and surveillance. Eligible studies were identified by two independent reviewers, and a systematic review was undertaken.

Results: Of 840 records, six guidelines and institutional consensus statements were identified, and an additional 13 studies were included. Most studies were cohort studies (n = 7), with the rest being case-control studies and reliability analyses. Risk stratification methods and surveillance strategies varied, with most studies recommending increased frequency (at least every 6 months) and higher-resolution imaging modalities (MRI over ultrasound) for higher-risk patients.

Conclusion: Despite several published guidelines, existing evidence regarding optimal surveillance strategies in localised primary UM is of variable quality, relying on cohort studies and limited by heterogeneity, as assessed by the modified Newcastle-Ottawa Scale. There is a clear need to further define local practices and outcomes to direct future guidelines.

Keywords: choroidal neoplasm; recurrence; surveillance; uveal melanoma.

PubMed Disclaimer

References

    1. A. B. Beasley, D. B. Preen, S. McLenachan, E. S. Gray, and F. K. Chen, “Incidence and Mortality of Uveal Melanoma in Australia (1982–2014),” British Journal of Ophthalmology [Internet] 107, no. 3 (2023): 406, http://bjo.bmj.com/content/107/3/406.abstract.
    1. Group TCOMS, “Assessment of Metastatic Disease Status at Death in 435 Patients With Large Choroidal Melanoma in the Collaborative Ocular Melanoma Study (COMS): COMS Report No. 15,” Archives of Ophthalmology [Internet] 119, no. 5 (2001): 670–676, https://doi.org/10.1001/archopht.119.5.670.
    1. M. Diener‐West, S. M. Reynolds, D. J. Agugliaro, et al., “Development of Metastatic Disease After Enrollment in the COMS Trials for Treatment of Choroidal Melanoma: Collaborative Ocular Melanoma Study Group Report No. 26,” Archives of Ophthalmology 123, no. 12 (2005): 1639–1643.
    1. A. Rola, H. Kalirai, A. F. G. Taktak, et al., “A Retrospective Analysis of 10 Years of Liver Surveillance Undertaken in Uveal Melanoma Patients Treated at the Supraregional “Liverpool Ocular Oncology Centre”, UK,” Cancers 14, no. 9 (2022): 2187.
    1. G. Stålhammar, “Comprehensive Causes of Death in Uveal Melanoma: Mortality in 1530 Consecutively Diagnosed Patients Followed Until Death,” JNCI Cancer Spectrum 7, no. 6 (2023): pkad097.

LinkOut - more resources