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Long term outcomes following surgery for pineal region tumors

  • Clinical Study
  • Published:
Journal of Neuro-Oncology Aims and scope Submit manuscript

Abstract

Purpose

Pineal region tumors are surgically demanding tumors to resect. Long term neuro-oncologic outcomes following surgical excision of tumors from this region have been underreported. We sought to define the long term outcomes of patients undergoing resection of pineal region tumors.

Methods

A retrospective analysis of a prospectively maintained database was performed on patients who underwent intended surgical excision of pineal region tumors. Overall survival (OS) and progression free survival (PFS) were the primary endpoints of this study. Factors associated with OS, PFS and the degree of resection were analyzed, along with 30-day complication rates and dependence on CSF diversion.

Results

Sixty-eight patients with a mean age of 30.9 ± 15.3 years were analyzed. The median clinical and radiographic follow-up was 95.7 and 48.2 months, respectively. The supracerebellar infratentorial and the occipital transtentorial corridors were utilized in the majority of cases (80.9%). The gross total resection (GTR) rate was 52.9% (n=36). The 5-year OS and PFS rates were 70.2% and 58.5%, respectively. Achieving GTR was associated with improved OS (HR 0.39, p = 0.03) and PFS (HR 0.4, p = 0.006). The 30-day mortality rate was 5.9%. The need for CSF diversion was high with 77.9% of patients requiring a shunt or ETV by last follow-up.

Conclusions

This is the first modern surgical series providing long term follow-up for patients undergoing surgical resection of pineal region tumors. Obtaining a GTR of these challenging tumors is beneficial with regards to PFS/OS. Higher grade tumors have diminished PFS/OS and are treated with adjuvant chemotherapy and/or radiotherapy.

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Data availability

All authors confirm the appropriateness of all datasets and software used for supporting the conclusion.

Code availability

Not applicable.

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Funding

The authors did not receive support from any organization for the submitted work.

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Authors and Affiliations

  1. Department of Neurosurgery, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA

    Matthew J. Shepard, Ali S. Haider, Sujit S. Prabhu, Raymond Sawaya, Franco DeMonte, Ian E. McCutcheon, Jeffrey S. Weinberg, Sherise D. Ferguson, Dima Suki & Frederick F. Lang

  2. Department of Pathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Gregory N. Fuller

  3. Brain Tumor Center, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Sujit S. Prabhu, Raymond Sawaya, Franco DeMonte, Ian E. McCutcheon, Jeffrey S. Weinberg, Sherise D. Ferguson, Dima Suki, Gregory N. Fuller & Frederick F. Lang

  4. Department of Neurosurgery, Allegheny Health Network, Pittsburgh, PA, USA

    Matthew J. Shepard

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  1. Matthew J. Shepard
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  9. Dima Suki
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  10. Gregory N. Fuller
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  11. Frederick F. Lang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by MJS. The first draft of the manuscript was written by MJS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Frederick F. Lang.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Informed consent

This study was performed after Institutional Review Board approval; the requirement for consent was waived for this retrospective analysis of an existing database.

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Shepard, M.J., Haider, A.S., Prabhu, S.S. et al. Long term outcomes following surgery for pineal region tumors. J Neurooncol 156, 491–498 (2022). https://doi.org/10.1007/s11060-021-03919-z

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  • DOI: https://doi.org/10.1007/s11060-021-03919-z

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