Clinical, Pathological, and Surgical Outcomes for Adult Pineoblastomas

Gener, Melissa; Conger, Andrew; Gompel, Jamie Van; Ariai, M. Shafie; Jentoft, Mark E.; Meyer, Fredric B.; Cardinal, Jeremy S.; Bonnin, José M.; Cohen-Gadol, Aaron

doi:10.1016/j.wneu.2015.08.005

Cited by 14 publications

(6 citation statements)

References 34 publications

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“…However, we have found no association between the 2, which supports the findings of several previous reports including Selvanathan et al and others. 12,16,19,23 Although maximum safe resection should be attempted, NCDB data suggest that it may be preferable to avoid aggressively chasing GTR in a challenging or dangerous tumor, such as 1 with extensive ventricular invasion. These results also indicate that leaving behind a portion of difficult-to-resect PPTID2 does not necessitate subsequent radiotherapy.…”

Section: Key Resultsmentioning

confidence: 99%

Malignant Pineal Parenchymal Tumors in Adults: A National Cancer Database Analysis

et al. 2022

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BACKGROUND: Limited retrospective data exist on malignant pineal parenchymal tumors (PPTs) in adults, and there are no large previous studies that review clinical outcomes across the 3 treatment arms of surgery, radiotherapy, and chemotherapy. As a result, optimal disease management has yet to be defined. OBJECTIVE: To evaluate treatment trends and perform survival analysis in adult PPT. METHODS: The National Cancer Database was queried for histologically confirmed PPT diagnosed from 2007 to 2016. Univariate and multivariate Cox regressions were used to evaluate the prognostic impact of covariates. Kaplan-Meier survival curves were generated for comparative subanalyses. RESULTS: Of the 251 patients who met inclusion criteria, 172 had PPTs of intermediate differentiation (PPTID) and 79 had pineoblastoma. A plurality of patients with pineoblastoma were treated with trimodal therapy (39.1%), whereas patients with PPTID were commonly treated with either surgery alone or surgery and radiation (33.7% each). Factors independently associated with improved overall survival include younger patient age, female sex, lower comorbidity score, lower tumor grade, and treatment with surgery or radiation (each P < .05). Subanalyses confirm the effect of radiation on survival in patients with grade III PPTID with subtotal resection; however, no survival benefit of adjuvant radiation is demonstrated in patients with grade II PPTID with subtotal resection. CONCLUSION: Although radiotherapy and surgery were found to increase survival in all patients with PPT, there was no demonstrable survival benefit of adjuvant radiation in surgically treated patients with grade II PPTID. This suggests that adjuvant radiotherapy may not add significant survival benefit in many adult patients with grade II PPTID.

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Section: Key Resultsmentioning

confidence: 99%

Malignant Pineal Parenchymal Tumors in Adults: A National Cancer Database Analysis

et al. 2022

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“…To our knowledge, this is the first case of a pineoblastoma occurring in a pregnant woman, presenting two important issues of interest. First of all, the histological subtype, since pineoblastoma of the adult age accounts approximately 200 cases reported starting from 1979 (9). Consequently, it is hard to produce a standardized management of these patients, despite the role of surgery being established as a mainstay for all pineal parenchymal tumors (10), as the extent of surgical resection represents a crucial factor for its impact on survival (11).…”

Section: Discussionmentioning

confidence: 99%

“…Particularly for complex shape volumes, Helical Tomotherapy provides remarkable results in terms of avoiding junctions and gaps, organs at risk sparing and also gaining a more homogeneous dose distribution and target coverage (15). Also, the role of chemotherapy is controversial and mainly investigated in paediatric patients (16)(17)(18), where pineoblastoma has a poorer prognosis (9). For adult patients, only limited data are available with inconclusive results (14,19).…”

Section: Discussionmentioning

confidence: 99%

A Case Report of Adult Pineoblastoma Occurring in a Pregnant Woman

Cuccia

Mortellaro²,

Cespuglio³

et al. 2019

Anticancer Res

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Background/Aim: Pineoblastoma of the adult age is an uncommon tumor with only 200 cases reported. A standardized approach for an optimal adjuvant strategy is currently lacking. The case presented herein also deals with the issue of central nervous system tumors in pregnancy. Case Report: A 21-year-old pregnant woman presented with massive hydrocephalus due to a mass in the pineal region detected with MRI. After positioning an urgent ventricular derivation, a cesarean section was performed. During a third ventriculocisternostomy, a biopsy revealed a pineoblastoma. After a maximal safe resection, postoperative craniospinal irradiation for a total dose of 36 Gy plus a sequential boost to the tumor bed to 54 Gy, and adjuvant chemotherapy with CDDP plus CCNU plus vincristine were performed. After one year, the patient is alive with no evidence of disease. Conclusion: The use of adjuvant radio-chemotherapy provided excellent outcomes in our case. The advanced gestational age facilitated the choice of the therapeutic strategy.

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“…Histopathologically, pineoblastomas are composed of small blue round cells with salt and pepper chromatin, inconspicuous nucleoli, and scant cytoplasm. Hypercellular tumors with uniform cells, high nuclear-tocytoplasmic ratio, and occasional rosettes are also easily noted features (9).…”

Section: Discussionmentioning

confidence: 99%

Treatment outcomes for pediatric pineoblastoma: a single institute experience in Taiwan

Kang¹,

Lin²,

Lee³

et al. 2018

Ther Radiol Oncol

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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.

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Clinical, Pathological, and Surgical Outcomes for Adult Pineoblastomas

Cited by 14 publications

References 34 publications

Malignant Pineal Parenchymal Tumors in Adults: A National Cancer Database Analysis

Malignant Pineal Parenchymal Tumors in Adults: A National Cancer Database Analysis

A Case Report of Adult Pineoblastoma Occurring in a Pregnant Woman

Treatment outcomes for pediatric pineoblastoma: a single institute experience in Taiwan

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