Patterns of care and follow-up care of patients with uveal melanoma in German-speaking countries: a multinational survey of the German Dermatologic Cooperative Oncology Group (DeCOG)

Theresa Steeb,Stefanie Sauder,Claudia Pföhler,Thomas Tüting,Peter Mohr,Verena Müller,Guido Bruning,Katharina C Kähler,Harald Löffler,Evelyn Dabrowski,Anja Gesierich,Reinhard Dummer,Ralf Gutzmer,Patrick Terheyden,Percy Lehmann,Kerstin Schatton,Lucie Heinzerling,Friedegund Meier,Rainer Rompel,Matthias Schmuth,Rose K C Moritz,Nicole Kreuzberg,Carmen Loquai,Ahn Van Nguyen,Ulrich Wesselmann,Alexander Thiem,Steffen Emmert,Sebastian Haferkamp,Elisabeth Livingstone,Markus Streit,Jessica C Hassel,Armin Bender,Christiane Bayerl,Markus Zutt,Carola Berking,Erika Richtig,Wolfgang Krapf,P Dücker ,Markus Meißner ,Jan C Simon ,E S Schultz ,P Elsner ,Alexander A Navarini ,Alexander H Enk ,Michael Max Sachse ,N Devereux ,Hans‐Joachim Schulze ,Edgar Dippel,Konstantin Drexler,Sergij Goerdt,Steven Goetze,Gerhard Weyandt,Christian Posch,Matthias Goebeler,Kjell M Kaume,Bastian Schilling,Christiane Pfeiffer,Max Schlaak,Lisa Zimmer,Julia Welzel,Mirjana Ziemer,Cornelia Mauch,Uwe Wollina,Lara Valeska Maul,Christoffer Gebhardt,Gesina Hansel,Anja Wessely,Dirk Debus,Mareike Alter,Dirk Schadendorf,Markus V Heppt

doi:10.1007/s00432-020-03450-0

Abstract

PurposeUveal melanoma (UM) is an orphan cancer of high unmet medical need. Current patterns of care and surveillance remain unclear as they are situated in an interdisciplinary setting.MethodsA questionnaire addressing the patterns of care and surveillance in the management of patients with uveal melanoma was distributed to 70 skin cancer centers in Austria, Germany and Switzerland. Frequency distributions of responses for each item of the questionnaire were calculated.Results44 of 70 (62.9%) skin cancer centers completed the questionnaire. Thirty-nine hospitals were located in Germany (88.6%), three in Switzerland (6.8%) and two in Austria (4.5%). The majority (68.2%) represented university hospitals. Most patients with metastatic disease were treated in certified skin cancer centers (70.7%, 29/41). Besides, the majority of patients with UM were referred to the respective skin cancer center by ophthalmologists (87.2%, 34/39). Treatment and organization of follow-up of patients varied across the different centers. 35.1% (14/37) of the centers stated to not perform any screening measures.ConclusionTreatment patterns of patients with uveal melanoma in Germany, Austria and Switzerland remain extremely heterogeneous. A guideline for the treatment and surveillance is urgently needed.

Highlights

Ocular melanoma is a rare cancer condition that can develop as uveal or conjunctival tumors
The explorative survey included questions in a multiple-choice format regarding various treatment approaches for primary and metastatic disease of ocular melanoma [i.e., Uveal melanoma (UM) and conjunctival melanoma (CM)], follow-up of patients, as well as items related to interdisciplinary cooperation
In 86.8% (33/38) of the centers, patients with UM or CM presented for the first time after histological confirmation of distant metastases, followed by presentation upon clinical or radiological suspicion of distant metastases in 83.8% (31/38)

Summary

Introduction

Ocular melanoma is a rare cancer condition that can develop as uveal or conjunctival tumors. Uveal melanoma (UM) represents one of the most common ocular malignancies among adults and accounts for about 5% of all melanoma. Journal of Cancer Research and Clinical Oncology (2021) 147:1763–1771 cases. With an incidence of 4–7 cases per million in Europe, it is much rarer than cutaneous melanoma (Mallone et al 2012). Therapeutic options of local disease include radiation therapies or surgical approaches like local resection and enucleation of the affected eye. These measures are highly effective to achieve local tumor control, up to 50% of patients develop distant metastases, which are mostly localized to liver and lungs (Bedikian 2006)

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Conclusion