Prognostic factors of pediatric pineal region tumors at a single institution

Abstract

Purpose: To identify factors of a worse prognosis among different histological types of pineal region tumors in pediatric patients treat at a single institution in a 30-year period. Material and Methods: 151 pediatric patients (< 18 years of age) treated between 1991 and 2020 were analyzed. Kaplan-Meyer survival curves were created and the log-rank test was used to compare the main prognostic factors in the different histological types. Results: Germinoma was found in 33.1%, with an overall 60-month survival rate of 88%; the female sex was the only factor of a worse prognosis. Non-germinomatous germ cell tumors were found in 27.1%, with an overall 60-month survival rate of 67.2%; metastasis upon diagnosis, residual tumor and the absence of radiotherapy were associated with a worse diagnosis. Pineoblastoma was found in 22.5%, with an overall 60-month survival rate of 40.7%; the male sex was the only factor of a worse prognosis; a tendency toward a worse outcome was found in patients < 3 years of age and those with metastasis upon diagnosis. Glioma was identified in 12.5%, with an overall 60-month survival rate of 72.6%; high grade gliomas were associated with a worse prognosis. Atypical teratoid rhabdoid tumors was found in 3.3% and all patients died within a 19-month period. Conclusion: Pineal region tumors are characterized by the heterogeneity of histological types, which exert an influence on the outcome. Knowledge of the prognostic factors for each histological types is of extreme importance to the determination of guided multidisciplinary treatment.

Treatment of Pineal Region Lesions in Children

“…Management of pineal region lesions is challenging, especially in children, due to deep-seated and important neurovascular structures surrounding the region 1 . Pineal region lesions are more common in children than adults, accounting for 3% to 11% of intracranial masses 2 . Surgical resection and radiotherapy have essential roles in the management of pineal region lesions, although the optimal therapeutic strategy for lesion management is controversial 3 .…”