Can Periodic Surveillance for Metastases Improve Clinical Outcome in Uveal Melanoma? Moving Towards International Guidelines

Uveal melanoma is a rare disease with a predominant propensity for liver metastasis. Prognosis in the metastatic setting is poor, and no treatments have been proven to extend survival to date. Surveillance for metastases is commonly performed in practice, although there is no unequivocal evidence of its benefit. Surveillance is however intuitively advantageous, allowing locoregional management of liver-only metastases, and facilitating early systemic treatment and particularly trial enrolment, and should, in our view, be considered good clinical practice. Several questions remain, including whom to screen, what modality to use, and for how long. In addition, further investigation is required into the incorporation of novel biomarkers and adjuvant strategies into surveillance.