Pineal Region Gliomas: A Single-Center Experience with 25 Cases

Li, Denghui; Wen, Rong; Gao, Yuan; Xu, Yangyang; Xiong, Botao; Gong, Feilong; Wang, Wei

doi:10.1016/j.wneu.2019.06.189

Cited by 10 publications

(29 citation statements)

References 38 publications

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“…All other patients underwent a diagnostic MRI because of newly developed symptoms that finally led to the diagnosis of a pineal lesion. Clinical symptoms consisted of headaches in 19…”

Section: Resultsmentioning

confidence: 99%

Management of pineal region tumors in a pediatric case series

et al. 2020

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Pineal region tumors commonly present with non-communicating hydrocephalus. These heterogeneous histological entities require different therapeutic regimens. We evaluated our surgical experience concerning procurance of a histological diagnosis, management of hydrocephalus, and choice of antitumoral treatment. We analyzed the efficacy of neuroendoscopic biopsy and endoscopic third ventriculocisternostomy (ETV) in patients with pineal region tumors between 2006 and 2019 in a single-center retrospective crosssectional study with regard to diagnostic yield, hydrocephalus treatment, as well as impact on further antitumoral management. Out of 28 identified patients, 23 patients presented with untreated hydrocephalus and 25 without histological diagnosis. One patient underwent open biopsy, and 24 received a neuroendoscopic biopsy with concomitant hydrocephalus treatment if necessary. Eighteen primary ETVs, 2 secondary ETVs, and 2 ventriculoperitoneal shunts (VPSs) were performed. Endoscopic biopsy had a diagnostic yield of 95.8% (23/24) and complication rates of 12.5% (transient) and 4.2% (permanent), respectively. ETV for hydrocephalus management was successful in 89.5% (17/19) with a median follow-up of more than 3 years. Following histological diagnosis, 8 patients (28.6%) underwent primary resection of their tumor. Another 9 patients underwent later-stage resection after either adjuvant treatment (n = 5) or for progressive disease during observation (n = 4). Eventually, 20 patients received adjuvant treatment and 7 were observed after primary management. One patient was lost to follow-up. Heterogeneity of pineal region tumor requires histological confirmation. Primary biopsy of pineal lesions should precede surgical resection since less than a third of patients needed primary surgical resection according to the German pediatric brain tumor protocols. Interdisciplinary decision making upfront any treatment is warranted in order to adequately guide treatment.

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“…All other patients underwent a diagnostic MRI because of newly developed symptoms that finally led to the diagnosis of a pineal lesion. Clinical symptoms consisted of headaches in 19…”

Section: Resultsmentioning

confidence: 99%

Management of pineal region tumors in a pediatric case series

et al. 2020

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“…Gliomas of the pineal region represent between 10 and 38% of the lesions [ 1 – 8 ]. According to the comprehensive review of Magrini et al, diffuse grade II astrocytomas are the most frequent subtype of tumor with 25% of the lesions, followed by glioblastoma with 19% of them [ 7 , 8 ]. In this series, PA (59%) were the most frequent gliomas of the pineal region.…”

Section: Discussionmentioning

confidence: 99%

“…While clear differences in the survival rates between low and high grade gliomas of the CNS are widely published [ 9 , 10 ], some discrepancies still exist regarding the survival outcome of diffuse grade II astrocytomas of the pineal region. Even though several publications on the surgical management of pineal region tumors analyze gliomas together with other types of tumors, large series specifically dealing with pineal region gliomas are almost absent in the literature [ 7 , 8 ]. A recent publication by Li et al compared survival rates of low (WHO grade I and II) and high grade gliomas (WHO grade III and IV) of the pineal region.…”

Section: Discussionmentioning

confidence: 99%

“…A recent publication by Li et al compared survival rates of low (WHO grade I and II) and high grade gliomas (WHO grade III and IV) of the pineal region. The mean survival rate of low grade gliomas (46% at a FU of 12.5 ± 11 months) contrasted with the mean survival rate of high grade gliomas (16% at a FU of 36 ± 23 months) [ 8 ]. The two diffuse grade II astrocytomas presented in that report were alive at 2 and 24 months of FU.…”

Section: Discussionmentioning

confidence: 99%

“…Pineal region gliomas originate from the pineal gland tissue or from the surrounding structures. Surgical series specifically dealing with pineal region gliomas are almost absent in the literature [ 7 , 8 ]. Whereas it is a general assumption that the extent of surgical resection correlates with survival outcomes of intracranial gliomas; the impact of the microsurgical resection on the long-term outcomes of pineal gliomas has been questioned [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Long-term survival outcomes of pineal region gliomas

et al. 2020

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Purpose Surgical series of pineal region gliomas are rarely available. Whereas it is a general assumption that the extent of surgical resection correlates with survival outcomes of intracranial gliomas; the impact of the microsurgical resection on the long-term outcomes of pineal gliomas has been questioned. We present a surgical series of pineal region gliomas with focus on the survival outcome analysis. Methods 17 histologically confirmed pineal region glioma patients classified as diffuse and non-diffuse gliomas were retrospectively analyzed. A detailed description of the series was followed by regression models to identify predictors of clinical outcomes. Uni- a multivariate survival analysis was performed to determine independent predictors of mortality. Results Although the number of treated patients was small, only WHO grade histopathology remained significant (p = 0.02) after multivariate survival analysis with extent of resection, age, tumor volume, and preoperative functional status. The extent of the surgical resection did not correlate with the disease survival rates of non-diffuse (p = 1), diffuse (p = 0.2), nor all gliomas (p = 0.6). 15 of 17 patients underwent gross total (nine patients) or subtotal resection. The preoperative functional status of the patients showed overall improvement on the immediate (p < 0.001) and long-term (p = 0.03) follow-up after 106 (3 – 324) months. Conclusion The extent of the surgical resection does not seem to significantly impact on the survival outcomes of pineal region gliomas. Thus, genotype and molecular features may essentially affect the outcome. Further research on the field is required. Electronic supplementary material The online version of this article (10.1007/s11060-020-03571-z) contains supplementary material, which is available to authorized users.

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Pineal Tumors

Park

Cho

2020

CyberKnife NeuroRadiosurgery

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Pineal Region Gliomas: A Single-Center Experience with 25 Cases

Cited by 10 publications

References 38 publications

Management of pineal region tumors in a pediatric case series

Management of pineal region tumors in a pediatric case series

Long-term survival outcomes of pineal region gliomas

Pineal Tumors

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