@article {Brouwer1277, author = {Niels J Brouwer and Marina Marinkovic and Sjoerd G van Duinen and Jaco C Bleeker and Martine J Jager and Gregorius P M Luyten}, title = {Treatment of conjunctival melanoma in a Dutch referral centre}, volume = {102}, number = {9}, pages = {1277--1282}, year = {2018}, doi = {10.1136/bjophthalmol-2017-311082}, publisher = {BMJ Publishing Group Ltd}, 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.}, issn = {0007-1161}, URL = {https://bjo.bmj.com/content/102/9/1277}, eprint = {https://bjo.bmj.com/content/102/9/1277.full.pdf}, journal = {British Journal of Ophthalmology} }