{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T09:33:52Z","timestamp":1775727232532,"version":"3.50.1"},"reference-count":50,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T00:00:00Z","timestamp":1700006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: Uveal melanoma (UM) is a rare intraocular tumor with a dismal prognosis once metastasized. This study provides a nationwide overview and time trends of patients diagnosed with primary UM in the Netherlands between 1989 and 2019. Methods: A retrospective population-based cohort study based on patients with primary UM from the database of the Netherlands Cancer Registry (NCR), linked with the national population registry Statistics Netherlands on inhabitants\u2019 cause of death. Two time periods (1989\u20132004, 2005\u20132019) were compared with descriptive statistics. Kaplan\u2013Meier and (multivariate) Cox proportional hazard models were used to assess changes over time for overall survival (OS) and cancer-specific survival (CSS). Results: In total, 5036 patients were analyzed with a median age of 64.0 years at the time of diagnosis. The number of patients increased over time. In the first (1989\u20132004) and second (2005\u20132019) period, 32% versus 54% of the patients received radiotherapy (p &lt; 0.001). The median FU time was 13.4 years. The median OS of the first and second periods was 9.5 (95% CI 8.7\u201310.3) versus 11.3 years (95% CI 10.3\u201312.3; p &lt; 0.001). The median CSS was 30.0 years (95% CI NA) in the first period and not reached in the second period (p = 0.008). In multivariate analysis (MVA), female gender (HR 0.85; 95% CI 0.79\u20130.92, p &lt; 0.001) and radiotherapy treatment (HR 0.73; 95% CI 0.64\u20130.83, p &lt; 0.001) were associated with better OS. Radiotherapy treatment (HR 0.74; 95% CI 0.61\u20130.90, p = 0.002) was also associated with better CSS. The period of diagnosis was not associated with OS or CSS. Conclusions: In this study of patients with primary UM, there was a shift to the diagnosis of smaller tumors, possibly due to stage migration. There was also an increase in eye-preserving treatments over time. OS and CSS were modestly improved in the second time period; however, the time period was not associated with OS or CSS in multivariate analyses.<\/jats:p>","DOI":"10.3390\/cancers15225419","type":"journal-article","created":{"date-parts":[[2023,11,15]],"date-time":"2023-11-15T10:57:46Z","timestamp":1700045866000},"page":"5419","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Time Trends in the Treatment and Survival of 5036 Uveal Melanoma Patients in The Netherlands over a 30-Year Period"],"prefix":"10.3390","volume":"15","author":[{"given":"Tha\u00efs M. L.","family":"Tong","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"},{"name":"Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esther","family":"Bastiaannet","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics and Prevention, University of Zurich, R\u00e4mistrasse 71, 8006 Z\u00fcrich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frank M.","family":"Speetjens","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christian U.","family":"Blank","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"},{"name":"Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregorius P. M.","family":"Luyten","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2261-3820","authenticated-orcid":false,"given":"Martine J.","family":"Jager","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Marinkovic","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T. H. Khanh","family":"Vu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6950-3376","authenticated-orcid":false,"given":"Coen R. N.","family":"Rasch","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carien L.","family":"Creutzberg","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0479-5587","authenticated-orcid":false,"given":"Jan-Willem M.","family":"Beenakker","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"},{"name":"Department of Ophthalmology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"},{"name":"Department of Radiation Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henk H.","family":"Hartgrink","sequence":"additional","affiliation":[{"name":"Department of Surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacobus J. J.","family":"Bosch","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"},{"name":"Centre for Human Drug Research, Zernikedreef 8, 2333 CL Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emine","family":"Kili\u00e7","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole C.","family":"Naus","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5915-3798","authenticated-orcid":false,"given":"Serdar","family":"Yavuzyigitoglu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline M.","family":"van Rij","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Erasmus Medical Center, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5258-291X","authenticated-orcid":false,"given":"Mark C.","family":"Burgmans","sequence":"additional","affiliation":[{"name":"Department of Radiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4814-6426","authenticated-orcid":false,"given":"Ellen H. 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