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@ARTICLE{Jabbarli:302822,
      author       = {L. Jabbarli and M. Lever and T. Kiefer and E. Biewald and
                      P. Rating and M. Guberina$^*$ and D. Flühs and N.
                      Guberina$^*$ and R. Jabbarli and M. Stuschke$^*$ and N. E.
                      Bechrakis and T. Tsimpaki and M. Fiorentzis},
      title        = {{L}ong-term outcome after treatment of large uveal
                      melanoma.},
      journal      = {International ophthalmology},
      volume       = {45},
      number       = {1},
      issn         = {0165-5701},
      address      = {Dordrecht},
      publisher    = {Springer Science + Business Media B.V.},
      reportid     = {DKFZ-2025-01362},
      pages        = {279},
      year         = {2025},
      abstract     = {The management of large uveal melanomas (UM) remains a
                      significant challenge. Treatment options include
                      radiotherapy alone or in combination with surgical
                      interventions. This study evaluates the long-term outcomes
                      of patients with large UM, focusing on the impact of
                      different treatment strategies.All consecutive patients with
                      large UM treated at our institution primarily with an
                      eye-salvaging approach-either bi-nuclide plaque
                      brachytherapy (BNPB) or endoresection (ER) following
                      neoadjuvant irradiation-between January 2014 and December
                      2020 were included in this study. Tumors with a thickness
                      greater than 7.0 mm that were not suitable for ruthenium-106
                      plaque brachytherapy were classified as large. The primary
                      study endpoints were the incidence of legal blindness of the
                      affected eye at 12 and 36 months, as well as eye
                      preservation and local tumor control at 36 months.Overall,
                      194 patients underwent ER, while 204 received BNPB. At 12
                      and 36 months, legal blindness was documented in $25.5\%$
                      and $39.8\%$ of patients, respectively. Three years after
                      treatment, eye preservation was achieved in $88.0\%$ of
                      cases, and local tumor control was observed in $92.9\%.$
                      Multivariable analysis revealed a significantly lower risk
                      of legal blindness at 12 months and secondary enucleation at
                      36 months in patients treated with ER without adjuvant
                      brachytherapy.Large UM can be effectively managed, achieving
                      both anatomical and functional eye preservation for several
                      years post-treatment. Among the approaches investigated, ER
                      following neoadjuvant irradiation demonstrated the most
                      favorable long-term outcomes, with a lower incidence of
                      legal blindness and secondary enucleation.},
      keywords     = {Humans / Melanoma: radiotherapy / Melanoma: diagnosis /
                      Melanoma: therapy / Melanoma: pathology / Uveal Neoplasms:
                      radiotherapy / Uveal Neoplasms: therapy / Uveal Neoplasms:
                      diagnosis / Uveal Neoplasms: pathology / Male / Female /
                      Uveal Melanoma / Brachytherapy: methods / Middle Aged / Aged
                      / Retrospective Studies / Follow-Up Studies / Treatment
                      Outcome / Time Factors / Adult / Aged, 80 and over /
                      Brachytherapy (Other) / Endoresection (Other) / Enucleation
                      (Other) / Large uveal melanoma (Other) / Local recurrence
                      (Other)},
      cin          = {ED01},
      ddc          = {610},
      cid          = {I:(DE-He78)ED01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40627056},
      pmc          = {pmc:PMC12238149},
      doi          = {10.1007/s10792-025-03624-0},
      url          = {https://inrepo02.dkfz.de/record/302822},
}