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Treatment of conjunctival melanoma in a Dutch referral centre
  1. Niels J Brouwer1,
  2. Marina Marinkovic1,
  3. Sjoerd G van Duinen2,
  4. Jaco C Bleeker1,
  5. Martine J Jager1,
  6. Gregorius P M Luyten1
  1. 1Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
  2. 2Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Dr Marina Marinkovic, Department of Ophthalmology, Leiden University Medical Center, P.O. box 9600, 2300 RC Leiden, The Netherlands; m.marinkovic{at}lumc.nl

Abstract

Aims To evaluate the treatment of conjunctival melanoma at a large Dutch referral centre and to make recommendations for clinical management.

Methods A retrospective review was performed of clinical and histological data of 70 patients treated for a primary conjunctival melanoma between 2001 and 2014 at the Leiden University Medical Center, Leiden, the Netherlands. Detailed follow-up data were available for all patients.

Results The mean follow-up time was 70.2 months. The overall 5-year recurrence rate was 29%, the 5-year metastasis rate 12% and the 5-year melanoma-related survival 90%. Treatment with excision alone had a significantly higher 5-year recurrence rate than (the combination of) other treatments (HR 3.73,95% CI 1.19 to 11.6, P=0.02). Initial treatment in an ocular oncology centre was associated with fewer recurrences compared with initial treatment by a local ophthalmologist of a referring centre (HR 0.32,95% CI 0.11 to 0.94, P=0.04), despite similar tumour baseline characteristics.

Conclusion Conjunctival melanoma is a rare disease with a high recurrence rate. A treatment strategy with local excision and adjuvant therapy gave a good clinical outcome, excision alone as a treatment should be considered obsolete. Initial treatment in a large referral centre improves clinical outcome, and patients should be referred to a specialised centre as soon as possible.

  • neoplasia
  • conjunctiva
  • treatment

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Footnotes

  • Contributors Design of the study: NJB, MM and MJJ. Data acquisition: NJB, MM and SGD. Data interpretation and critical revision and approval of the manuscript: all authors. Drafting the manuscript: NJB.

  • Funding NJB received a MD/PhD programme grant from the Leiden University Medical Center.

  • Competing interests None declared.

  • Ethics approval The institutional medical ethics committee agreed with this retrospective study; the study adhered to the tenets of the Declaration of Helsinki.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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