{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T01:36:45Z","timestamp":1777081005142,"version":"3.51.4"},"reference-count":34,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:00:00Z","timestamp":1751932800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100017590","name":"Universit\u00e4tsklinikum Essen","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100017590","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Ophthalmol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All consecutive patients with large UM treated at our institution primarily with an eye-salvaging approach\u2014either bi-nuclide plaque brachytherapy (BNPB) or endoresection (ER) following neoadjuvant irradiation\u2014between January 2014 and December 2020 were included in this study. Tumors with a thickness greater than 7.0\u00a0mm 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\u00a0months, as well as eye preservation and local tumor control at 36\u00a0months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 194 patients underwent ER, while 204 received BNPB. At 12 and 36\u00a0months, 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\u00a0months and secondary enucleation at 36\u00a0months in patients treated with ER without adjuvant brachytherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10792-025-03624-0","type":"journal-article","created":{"date-parts":[[2025,7,8]],"date-time":"2025-07-08T00:22:05Z","timestamp":1751934125000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Long-term outcome after treatment of large uveal melanoma"],"prefix":"10.1007","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7370-5077","authenticated-orcid":false,"given":"Leyla","family":"Jabbarli","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mael","family":"Lever","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tobias","family":"Kiefer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Biewald","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philipp","family":"Rating","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"Guberina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirk","family":"Fl\u00fchs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nika","family":"Guberina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramazan","family":"Jabbarli","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Stuschke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos E.","family":"Bechrakis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theodora","family":"Tsimpaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miltiadis","family":"Fiorentzis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,7,8]]},"reference":[{"issue":"11","key":"3624_CR1","doi-asserted-by":"publisher","first-page":"2223","DOI":"10.1016\/S0161-6420(03)00661-4","volume":"110","author":"I Puusaari","year":"2003","unstructured":"Puusaari I, Heikkonen J, Summanen P, Tarkkanen A, Kivela T (2003) Iodine brachytherapy as an alternative to enucleation for large uveal melanomas. 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Ethical approval was obtained from the Institutional Ethics Committee (Medical faculty of the University Duisburg-Essen, registration number 20\u20139165-BO).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"All patients signed the informed consent within the written treatment contract on admission.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"The authors affirm that human research participants provided informed consent for publication of the images in Figs.\n                      \n                      a, b.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to publish"}}],"article-number":"279"}}