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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.摘要: 眼科能成功治疗葡萄膜黑色素瘤, 并有效控制葡萄膜黑色素瘤的发展转移。尽管如此, 仍有大量患者发生转移, 葡萄膜黑色素瘤主要转移到肝脏并导致死亡。目前世界上关于葡萄膜黑色素瘤肝脏转移定期监测的模式、频率、持续时间及实用程度并没有共识, 且没有已发表的方案。苏格兰眼肿瘤协会(SOOS)建立了苏格兰共识声明小组(SCSG), 小组成员包括眼肿瘤医生、肿瘤科医生、放射科医生以及一位作为非专业人员的葡萄膜黑色素瘤患者。该小组对文献进行了广泛回顾和讨论, 并且对苏格兰后葡萄膜黑色素瘤患者的监测达成共识。该共识声明小组将提出框架以指导每位患者的病情监测, 并且在病情上对所有患者保持公开透明。SCSG并未找到充足证据作为该策略的基础。该临床共识建议将所有患者根据风险分级分为低、中、高风险组, 定义每个组的监测模式及持续时间。该共识补充说明了全英国葡萄膜黑色素瘤国家指南, 并促使在苏格兰采用更统一的并基于共识的监测方法。它已在全苏格兰内被所有医生作为指南, 并向患者提供一个公众开放的网站。. |
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