Extent of Resection and Long-Term Survival of Pineal Region Tumors in Helsinki Neurosurgery

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Choque-Velasquez , J , Resendiz-Nieves , J , Jahromi , B R , Colasanti , R , Raj , R , Vehviläinen , J , Tynninen , O , Collan , J , Niemelä , M & Hernesniemi , J 2019 , ' Extent of Resection and Long-Term Survival of Pineal Region Tumors in Helsinki Neurosurgery ' , World Neurosurgery , vol. 131 , pp. E379-E391 . https://doi.org/10.1016/j.wneu.2019.07.169

Title: Extent of Resection and Long-Term Survival of Pineal Region Tumors in Helsinki Neurosurgery
Author: Choque-Velasquez, Joham; Resendiz-Nieves, Julio; Jahromi, Behnam Rezai; Colasanti, Roberto; Raj, Rahul; Vehviläinen, Juho; Tynninen, Olli; Collan, Juhani; Niemelä, Mika; Hernesniemi, Juha
Contributor organization: Clinicum
HUS Neurocenter
Neurokirurgian yksikkö
University of Helsinki
Staff Services
Helsinki University Hospital Area
Department of Pathology
Department of Oncology
HUS Comprehensive Cancer Center
Department of Neurosciences
Date: 2019-11
Language: eng
Number of pages: 13
Belongs to series: World Neurosurgery
ISSN: 1878-8750
DOI: https://doi.org/10.1016/j.wneu.2019.07.169
URI: http://hdl.handle.net/10138/318329
Abstract: BACKGROUND: Pineal region tumors represent challenging surgical lesions with wide ranges of survival reported in different surgical series. In this article, we emphasize the role of complete microsurgical resection (CMR) to obtain a favorable long-term outcome of pineal region tumors. METHODS: We report a retrospective study of pineal region tumors operated on in Helsinki Neurosurgery between 1997 and 2015. Information was obtained from the hospital records, and an evaluation of the Finnish population register was conducted in July 2018 to determine the current status of the patients. RESULTS: A total of 76 pineal region tumors were operated on. The survival was 62% at a mean follow-up of 125 +/- 105 months (range, 0-588 months), and the disease-related mortality was limited to 14 patients (18.4%). Up to July 2018, 29 patients had died. Two patients died 1 and 3 months after surgery of delayed thalamic infarctions, 12 patients of disease progression, and 15 had non-disease-related deaths. Only 1 patient was lost in the long-term follow-up. Ten of 14 disease-related deaths occurred during the first 5 years of follow-up: 5 diffuse gliomas, 3 germ cell tumors, 1 grade II-III pineal parenchymal tumor of intermediate differentiation, and 1 meningioma. CMR was linked to better tumor-free survival and long-term survival, with the exception of diffuse gliomas. CONCLUSIONS: CMR, in the setting of a multidisciplinary management of pineal region tumors, correlates with favorable survival and with minimal mortality. Surgically treated grade II-IV gliomas constitute a particular group with high mortality within the first 5 years independently of the microsurgical resection.
Subject: Microneurosurgery
Multidisciplinary management
Pineal region lesions
Pineal tumors
Sitting position
Supracerebellar infratentorial approach
3112 Neurosciences
3124 Neurology and psychiatry
3126 Surgery, anesthesiology, intensive care, radiology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: acceptedVersion

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