Background: Our purpose was to evaluate the clinical outcomes of pediatric pineoblastoma patients after multimodality treatment. Methods: The medical records of 11 children with pineoblastomas treated at Taipei Veterans General Hospital between 1991 and 2006 were retrospectively reviewed. There were 7 females (63.6%) and 4 males (36.4%) with a median age at diagnosis of 5.25 years (range, 1.47-16.8 years). Age, sex, symptoms, pathological findings, treatment modalities, failure patterns, recurrence date, death date, and toxicities were recorded. Survival curves were estimated with the Kaplan-Meier method, and univariate Cox proportional hazards models were used to identify possible risk factors. Results: The median overall survival was 2.3 years, with 2-and 5-year survival rates of 63.6% and 36.4%, respectively. Eight patients (72.7%) died after serial treatments, and extensive seeding with multi-organ failure was the most common failure pattern. Three patients (27.2%) were alive without disease recurrence. Kaplan-Meier survival curves showed a significant difference (P<0.05) when compared by age at diagnosis (over or under 3 years old) (P=0.0014). Two out of the three long-term survivors received stereotactic biopsy, craniospinal irradiation (CSI) with focal boost, and chemotherapy without radical surgery. Conclusions: Our results showed survival was associated with age at diagnosis. Long-term survival can be achieved for patients who receive radiotherapy plus chemotherapy. Further studies are needed to determine the best treatment options for pediatric pineoblastoma patients.

ObjectiveTo evaluate the relationship between haemorrhoids and Graves’ disease (GD).SettingUsing the nationwide data from Taiwan’s Longitudinal Health Insurance Database.ParticipantsWe conducted a retrospective study, stratified patients by International Classification of Diseases, Ninth Revision, Clinical Modification disease code and compared the incidence rate of GD between patients with and without haemorrhoids. The study period was from 2000 to 2010, with exclusion of patients with diagnosed haemorrhoids before 2000 or after 2009, and we analysed the HR of GD in the univariable and multivariable models as well as the cumulative incidence curves of GD by using Kaplan-Meier curves.ResultThis study included 13 165 and 52 660 patients with and without haemorrhoids, respectively. The mean follow-up duration was approximately 6 years. The incidence rate of GD was 1.57 and 1.13 per 1000 person-years in patients with and without haemorrhoids, respectively. The area under the cumulative incidence curve of GD in patients with haemorrhoids was higher than that of patients without haemorrhoids. The risk of GD increased by 1.39 times (95% CI 1.13 to 1.71) in patients with haemorrhoids compared with patients without haemorrhoids. In the subgroup analysis, women with haemorrhoids had a higher risk of GD (adjusted HR 1.44; 95% CI 1.13 to 1.83). Patients with haemorrhoids aged 30–39 years were more likely to develop GD (adjusted HR 1.73; 95% CI 1.18 to 2.55).ConclusionThe findings of this study indicate that patients with haemorrhoids may have an increased risk of GD compared with other potential confounding factors.