Mucosal Melanoma Guidelines Project

Phase I: Ano-uro-genital Mucosal Melanoma Guideline Project

Over the past two years an expert Guideline Development Group (GDG) has been developing UK clinical guidelines for ano-uro-genital mucosal melanoma on behalf of Melanoma Focus. The work of the GDG is in its final stages following a successful consultation process during September and October 2017. The final guidelines and supporting material are now being drafted and will be made available on this website.

Background

The Guideline Development Group, set up by Melanoma Focus in 2016, consists of clinicians specialising in medical & clinical oncology, surgery, gynaecology, radiology and histopathology, as well as a nurse and a patient representative. The first guideline addresses ano-uro-genital melanoma. This will be followed by a guideline concentrating on sino-nasal melanoma.

Given the disease’s rarity, no randomised controlled trials have been identified for mucosal melanoma, but there is a large body of information relating treatments to outcomes. The challenge has been to identify the relevance of the published data to current clinical practice and produce agreed recommendations to guide healthcare professionals and inform patients and their carers.

The GDG was led by Professor Martin Gore, with project management and methodological support provided by the Project Manager, Mrs Nancy Turnbull.

This initiative follows the charity’s support for a group that successfully developed guidelines for uveal melanoma, receiving accreditation from The National Institute for Health and Care Excellence (NICE) in January 2015 (click here for further information).

The Mucosal Melanoma Guidelines were developed in accordance with a Melanoma Focus manual, Guideline Development Methodology. The Melanoma Focus development methods have been accredited by NICE as complying with their AGREE II criteria for the rigorous development of evidence-based guidelines. This replaces the methodology used in the drafting of the Uveal Melanoma Guidelines.

Membership of the Ano-Uro-Genital Mucosal Melanoma Guideline Development Group

Professor Martin Gore Consultant Medical Oncologist and GDG Chairman Royal Marsden NHS Foundation Trust
Dr Izhar Bagwan Consultant Histopathologist Royal Surrey County Hospital NHS Foundation Trust
Dr Ruth Board Consultant Medical Oncologist Lancashire Teaching Hospitals NHS Foundation Trust
Miss Sharon Capper Macmillan Urology Clinical Nurse Specialist Christie NHS Foundation Trust
Professor Sarah Coupland Honorary Consultant Histopathologist University of Liverpool
Dr Susan Lalondrelle Consultant Clinical Oncologist Royal Marsden NHS Foundation Trust
Ms Antonia Mayberry Patient Representative Rochdale
Mr Asif Muneer Consultant Urological Surgeon & Andrologist University College London Hospitals NHS Foundation Trust
Ms Karen Nugent Honorary Consultant Colorectal Surgeon University Hospital Southampton NHS Foundation Trust
Mr Pubudu Pathiraja Consultant in Gynaecology Oncology Oxford University Hospitals NHS Foundation Trust
Dr Miranda Payne Consultant Medical Oncologist Oxford University Hospitals NHS Foundation Trust
Mr Howard Peach Consultant Plastic & Reconstructive Surgeon Leeds Teaching Hospitals NHS Trust
Mr Henry Smith Research Fellow and Rapporteur of the Guideline Development Group Royal Marsden NHS Foundation Trust
Dr Jonathan Smith Consultant Radiologist Leeds Teaching Hospitals NHS Trust
Mr Myles Smith Consultant General Surgeon & Surgical Oncologist Royal Marsden NHS Foundation Trust
Dr Sarah Westwell Consultant Clinical Oncologist Brighton and Sussex University Hospitals NHS Trust
Mr Ewan Wilson Consultant Plastic & Reconstructive Surgeon North Bristol NHS Trust
Observers
Mr Simon Rodwell Chief Executive Melanoma Focus
Mrs Nancy Turnbull Project Manager

Melanoma Focus is extremely grateful to the group for their generous donation of skill, time and effort.

 

Phase II: Sino-Nasal/Head & Neck Mucosal Melanoma Guideline Project

Melanoma Focus is in the final stages of setting up a Guideline Development Group (GDG) to produce a national clinical guideline for sino-nasal/head & neck mucosal melanoma.

Background

Mucosal melanomas are rare, representing only about 1-2% of all melanomas. 55% of all primary mucosal melanomas occur in the head and neck region, with the nose and paranasal sinuses being the most common sites. Surgery at all stages frequently involves complex decisions about risk and benefit, and the value of adjuvant treatment – drug therapy or radiotherapy – is unclear. Medical treatment of advanced melanoma is evolving rapidly and its relevance to this group of patients requires clarification. There is no agreement about diagnostic imaging techniques or follow-up protocols. There is therefore a need for clinical guidance in this area.

As the principal UK melanoma charity, Melanoma Focus has a remit to lead in the development of clinical guidance for melanoma and is well-placed to sponsor the production of a guideline for sino-nasal/head & neck mucosal melanoma. This guideline will be developed in compliance with NICE accreditation requirements and published in relevant medical journals.

This initiative follows the charity’s support for the successful development of guidelines for uveal melanoma and ano-uro-genital mucosal melanoma (see description of Phase I above). Melanoma Focus has NICE accreditation for its guideline methodology – see Guideline Development Methodology.

Composition and work of the GDG

The GDG will be led by Professor Kevin Harrington, with project management and methodological support & funding by Melanoma Focus. It will comprise approximately 12 members from appropriate specialisations and interests:

• Maxillofacial/Head & Neck Surgeon
• ENT Surgeon
• Oral & Facial Plastic Surgeon
• Medical Oncologist with an interest in melanoma
• Clinical Oncologist with an interest in head and neck oncology
• Surgeon with a major interest in melanoma
• Pathologist with expertise in melanoma and head and neck oncology
• Radiologist with expertise in melanoma and head and neck oncology
• CNS specialising in head and neck cancers
• CNS specialising in melanoma
• Patient Advocates/Representatives

Timescales

We expect the process to take 18-24 months and involve 9 to 12 one-day meetings in London. The first meeting of the GDG will be held on 13 July 2018.

 

 






 





 

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