A research study to investigate how often patients with uveal melanoma should have liver scans

Uveal melanoma (UM) is the most common type of primary cancer that develops in the eye of adults. UM can spread from the eye to other parts of the body. This process is called ‘metastasis’. Metastatic UM most often develops in the liver, but can also affect the lungs, bones and skin. Most patients with liver spread die within a year of the detection of the secondary tumours in the liver. Unfortunately, there is no effective treatment at present. Various features have been linked with the risk of UM spread to the liver. These include: the age and gender of the patient, the tumour size and exact location within the eye, some histological features seen under the microscope as well as UM genetic subtype.

UM prognostication (assessing the risk of metastatic UM)

After treatment of the eye cancer, UM patients undergo liver scans to detect the presence of any metastatic disease, with the aim of detecting this as early as possible. To improve patients' quality of life and due to logistic reasons, it is important to find out how often patients require liver scans. The LOORG has designed a computer programme called the Liverpool Uveal Melanoma Prognostication Online Version 3 (LUMPO3) that calculates the risk of developing metastatic disease in each individual UM patient, and estimates the timeline that this may occur.

To improve LUMPO3, we need to know if it can also be reliably used to recommend the frequency of liver scans in each UM patient. For this, the LOORG is conducting a study that will review the medical reports of liver scans performed on UM patients diagnosed between January 2008 and January 2018 at the Liverpool Ocular Oncology Centre, Royal Liverpool University Hospital. Only those UM patients who have provided consent to take part in the Ocular Oncology Biobank (OOB) will be included in this study. Details, such as date of detection of UM deposits in the liver, their number and size, will be recorded. These findings will be compared with the LUMPO3 predictions, to see if some of the liver scans could have been avoided (and therefore were potentially ‘unnecessary’).

As a result of this project, it will be possible:

• To retrospectively compare the number of liver scans performed using current practice, with the number that would have been performed using LUMPO3.
• To determine the factors that influence decision making regarding patient follow-up, using statistical analysis. Such factors may include for example time from the onset of metastases to detection, probability of death after metastasis, time from detection to death, and reduction to quality of life resulting from all that was involved in the scanning procedures.

Further developments on this study will be published on our website. 

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