PT  - JOURNAL ARTICLE
AU  - Niels J Brouwer
AU  - Marina Marinkovic
AU  - Sjoerd G van Duinen
AU  - Jaco C Bleeker
AU  - Martine J Jager
AU  - Gregorius P M Luyten
TI  - Treatment of conjunctival melanoma in a Dutch referral centre
AID  - 10.1136/bjophthalmol-2017-311082
DP  - 2017 Nov 09
TA  - British Journal of Ophthalmology
PG  - bjophthalmol-2017-311082
4099  - http://bjo.bmj.com/content/early/2017/11/09/bjophthalmol-2017-311082.short
4100  - http://bjo.bmj.com/content/early/2017/11/09/bjophthalmol-2017-311082.full
AB  - 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.