{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T08:05:54Z","timestamp":1789113954851,"version":"build-2803163510"},"reference-count":24,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Background:<\/jats:title>\n Pineal region tumors are uncommon lesions that present significant surgical challenges due to their deep location, proximity to critical neurovascular structures, and frequent association with obstructive hydrocephalus. Although several operative corridors are available, factors influencing postoperative functional recovery remain poorly defined. This study evaluated clinical, radiological, and surgical determinants of functional outcomes following surgery for pineal region tumors.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We retrospectively reviewed 57 consecutive patients who underwent surgical treatment for pineal region tumors between March 2016 and August 2025 at a tertiary neurosurgical center. Clinical, radiological, operative, pathological, and follow-up data were analyzed. Functional outcomes were assessed using the Karnofsky Performance Scale (KPS). Primary functional outcome was postoperative change in \u0394KPS, with admission KPS analyzed separately to identify baseline determinants of preoperative functional status.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The mean age was 36.5 years, and 59.6% of patients were male. Gross total resection was achieved in 42 patients (73.7%), subtotal resection in 7 (12.3%), and biopsy alone in 8 (14.0%). Hydrocephalus was present in 45 patients (78.9%), with 12 (21.1%) ultimately requiring permanent cerebrospinal fluid diversion. The posterior interhemispheric transsplenial approach was the most commonly used surgical corridor (36.8%). Increasing age and larger tumor volume independently predicted lower admission KPS scores, whereas lower preoperative KPS was associated with greater postoperative functional improvement. Surgical approach, extent of resection, pathology, and hydrocephalus treatment strategy were not significantly associated with functional recovery. The complication rate was 10.5%, with one perioperative mortality.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Favorable functional outcomes and high resection rates can be achieved using multiple microsurgical and endoscopic approaches when operative corridor selection is tailored to individual anatomy. Within the limitations of this retrospective cohort, postoperative functional recovery was more strongly associated with baseline patient- and tumor-related factors than with the operative corridor selected. No statistically significant association between surgical approach and postoperative functional recovery was identified.<\/jats:p>\n <\/jats:sec>","DOI":"10.25259\/sni_720_2026","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T07:09:30Z","timestamp":1789110570000},"page":"513","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional outcomes and anatomy-based surgical strategy in 57 pineal region tumors"],"prefix":"10.25259","volume":"17","author":[{"given":"Vartika","family":"Gupta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"10.25259\/SNI_720_2026\/ref-1","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1227\/00006123-198205000-00001","article-title":"Transcallosal, interfornicial approaches for lesions affecting the third ventricle: Surgical considerations and consequences","volume":"10","author":"Apuzzo","year":"1982","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_720_2026\/ref-2","first-page":"ons159","article-title":"The value of endoscopy in the total resection of pineocytomas","volume":"67","author":"Broggi","year":"2010","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_720_2026\/ref-3","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1007\/BF01417679","article-title":"Surgical management of pineal region tumors","volume":"134","author":"Bruce","year":"1995","journal-title":"Acta Neurochir (Wien)"},{"key":"10.25259\/SNI_720_2026\/ref-4","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/j.1600-0447.1944.tb04560.x","article-title":"A new approach for the removal of tumors of the third ventricle","volume":"19","author":"Busch","year":"1944","journal-title":"Acta Psychiatr Scand"},{"key":"10.25259\/SNI_720_2026\/ref-5","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1016\/j.jocn.2009.12.007","article-title":"Immediate morbidity and mortality associated with transcallosal resection of tumors of the third ventricle","volume":"17","author":"Hassaneen","year":"2010","journal-title":"J Clin Neurosci"},{"key":"10.25259\/SNI_720_2026\/ref-6","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1016\/j.surneu.2008.07.019","article-title":"Microsurgical management of pineal region lesions: personal experience with 119 patients","volume":"70","author":"Hernesniemi","year":"2008","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI_720_2026\/ref-7","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1001\/archneurpsyc.1937.02260140171009","article-title":"Extirpation of a huge pinealoma from a patient with pubertas praecox: A new operative approach","volume":"37","author":"Horrax","year":"1937","journal-title":"Arch Neurol Psychiatry"},{"key":"10.25259\/SNI_720_2026\/ref-8","doi-asserted-by":"crossref","first-page":"550","DOI":"10.3171\/jns.1971.35.5.0550","article-title":"Excision of pineal tumors","volume":"35","author":"Jamieson","year":"1971","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_720_2026\/ref-9","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1093\/neuonc\/noab106","article-title":"The 2021 WHO classification of tumors of the central nervous system: A summary","volume":"23","author":"Louis","year":"2021","journal-title":"Neuro Oncol"},{"key":"10.25259\/SNI_720_2026\/ref-10","doi-asserted-by":"crossref","first-page":"85","DOI":"10.4103\/2152-7806.99911","article-title":"Posterior cranial fossa tumors: results and prognostic factors in a consecutive series of 14 operated patients by occipital transtentorial approach","volume":"3","author":"Maselli","year":"2012","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_720_2026\/ref-11","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1016\/B978-1-4377-0701-4.00037-3","article-title":"Tumours of the pineal region","volume-title":"Principles of Neurological Surgery","author":"Matula","year":"2012","edition":"3rd ed"},{"key":"10.25259\/SNI_720_2026\/ref-12","doi-asserted-by":"crossref","first-page":"168","DOI":"10.1016\/j.neuchi.2013.12.005","article-title":"The sub-occipital transtentorial approach revisited base on our own experience","volume":"61","author":"Mottolese","year":"2015","journal-title":"Neurochirurgie"},{"key":"10.25259\/SNI_720_2026\/ref-13","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1016\/j.neuchi.2014.02.004","article-title":"Supracerebellar infratentorial approach for pineal region tumors: Our surgical and technical considerations","volume":"61","author":"Mottolese","year":"2015","journal-title":"Neurochirurgie"},{"key":"10.25259\/SNI_720_2026\/ref-14","doi-asserted-by":"crossref","first-page":"154","DOI":"10.4103\/2152-7806.122504","article-title":"The infratentorial supracerebellar approach in surgery of lesions of the pineal region","volume":"4","author":"Oliveira","year":"2013","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_720_2026\/ref-15","first-page":"2116","article-title":"Surgical results in tumors of the thalamic and quadrigeminal regions","volume":"50","author":"Oppenheim","year":"1913","journal-title":"Berl Klin Wochenschr"},{"key":"10.25259\/SNI_720_2026\/ref-16","doi-asserted-by":"crossref","first-page":"1860","DOI":"10.1007\/s00415-012-6421-x","article-title":"Functional consequences of a section of the anterior part of the body of the corpus callosum: Evidence from an interhemispheric transcallosal approach","volume":"259","author":"Peltier","year":"2012","journal-title":"J Neurol"},{"key":"10.25259\/SNI_720_2026\/ref-17","doi-asserted-by":"crossref","first-page":"706","DOI":"10.3171\/jns.1966.25.6.0706","article-title":"The right occipital approach to a pinealoma","volume":"25","author":"Poppen","year":"1966","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_720_2026\/ref-18","doi-asserted-by":"crossref","first-page":"357","DOI":"10.3171\/jns.1968.28.4.0357","article-title":"Pinealomas and tumors of the posterior portion of the third ventricle","volume":"28","author":"Poppen","year":"1968","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_720_2026\/ref-19","doi-asserted-by":"crossref","first-page":"741","DOI":"10.3109\/00207454.2013.878341","article-title":"The unilateral occipital transtentorial approach for pineal region meningiomas: A report of 15 cases","volume":"124","author":"Qiu","year":"2014","journal-title":"Int J Neurosci"},{"key":"10.25259\/SNI_720_2026\/ref-20","doi-asserted-by":"crossref","first-page":"197","DOI":"10.3171\/jns.1971.35.2.0197","article-title":"The infratentorial supracerebellar approach to pineal lesions","volume":"35","author":"Stein","year":"1971","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_720_2026\/ref-21","first-page":"216","article-title":"A surgical approach for the removal of certain pineal tumours","volume":"37","author":"Van Wagenen","year":"1931","journal-title":"Surg Gynecol Obstet"},{"key":"10.25259\/SNI_720_2026\/ref-22","article-title":"Central Nervous System Tumours","volume-title":"WHO Classification of Tumours Series","author":"WHO Classification of Tumours Editorial Board","year":"2021","edition":"5th ed"},{"key":"10.25259\/SNI_720_2026\/ref-23","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1227\/00006123-199501000-00015","article-title":"Transcallosal removal of lesions affecting the third ventricle: An anatomic and clinical study","volume":"36","author":"Woiciechowsky","year":"1995","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_720_2026\/ref-24","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1634\/theoncologist.2008-0037","article-title":"Pediatric central nervous system germ cell tumors: a review","volume":"13","author":"Zechevarr\u00eda","year":"2008","journal-title":"Oncologist"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/functional-outcomes-and-anatomy-based-surgical-strategy-in-57-pineal-region-tumors\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/functional-outcomes-and-anatomy-based-surgical-strategy-in-57-pineal-region-tumors\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T07:10:33Z","timestamp":1789110633000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/functional-outcomes-and-anatomy-based-surgical-strategy-in-57-pineal-region-tumors\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,11]]},"references-count":24,"alternative-id":["10.25259\/SNI_720_2026"],"URL":"https:\/\/doi.org\/10.25259\/sni_720_2026","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9,11]]},"article-number":"513"}}