{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T12:10:33Z","timestamp":1783080633936,"version":"3.54.6"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2012,8]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The optimal management of pineocytomas remains controversial. Although the value of complete microsurgical removal is well accepted, gross-total resection is not always feasible. Data regarding the role of postoperative adjuvant stereotactic radiosurgery (SRS) for residual disease is limited and conflicting. Here, the authors review the largest single-institution experience with multimodal pineocytoma management in an effort to quantify the utility of adjuvant radiosurgical treatment of residual disease.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>The medical records and radiographic studies for all patients with histologically confirmed pineocytoma at the Barrow Neurological Institute between 1999 and 2011 were retrospectively reviewed. Clinical and radiographic data, including the volumetric extent of resection, were collected retrospectively, and Kaplan-Meier analysis was used to identify progression-free survival.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>Fourteen adults with newly diagnosed pineocytomas were surgically treated in the period from 1999 to 2011. The median clinical and radiographic follow-ups were 44 and 53 months, respectively. Twelve patients (86%) underwent microsurgical removal and 2 (14%) underwent endoscopic biopsy. Five patients (36%) had complete resections and 9 (64%) demonstrated residual disease. Three patients (21%) presented with radiographic recurrence at a median interval of 43 months after initial treatment (range 13\u201383 months). At the time of recurrence, the median preoperative tumor volume was 2.6 cm<jats:sup>3<\/jats:sup>. Adjuvant SRS was used to treat 3 subtotally resected tumors (33%) following initial presentation and 2 (66%) at the time of recurrence. Among patients with subtotally resected tumors, progression-free survival was significantly longer (p &lt; 0.05) for those who did as compared with those who did not undergo adjuvant radiosurgery. To date, no patient who underwent adjuvant radiosurgery has demonstrated radiographic or clinical evidence of disease progression.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Microsurgical removal remains the definitive treatment for pineocytomas, yet residual disease can be effectively controlled using adjuvant SRS.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2012.5.jns1251","type":"journal-article","created":{"date-parts":[[2012,6,15]],"date-time":"2012-06-15T15:25:47Z","timestamp":1339773947000},"page":"212-217","source":"Crossref","is-referenced-by-count":31,"title":["Long-term radiosurgical control of subtotally resected adult pineocytomas"],"prefix":"10.3171","volume":"117","author":[{"given":"David A.","family":"Wilson","sequence":"first","affiliation":[{"name":"Division of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Al-Wala","family":"Awad","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Brachman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen W.","family":"Coons","sequence":"additional","affiliation":[{"name":"Division of Neuropathology, Barrow Neurological Institute; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heyoung","family":"McBride","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"Youssef","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Nakaji","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew G.","family":"Shetter","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kris A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert F.","family":"Spetzler","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nader","family":"Sanai","sequence":"additional","affiliation":[{"name":"Division of Neurological Surgery,"},{"name":"Barrow Brain Tumor Research Center,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"Suppl","key":"b1-jns1251","series-title":"J Neurosurg","first-page":"175","article-title":"Pineal tumors: analysis of treatment results in 20 patients","volume":"102","author":"Amendola","year":"2005"},{"issue":"3 Suppl Operative","key":"b2-jns1251","series-title":"Neurosurgery","first-page":"ons159","article-title":"The value of endoscopy in the total resection of pineocytomas","volume":"67","author":"Broggi","year":"2010"},{"key":"b3-jns1251","series-title":"Acta Neurochir (Wien)","first-page":"130","article-title":"Surgical management of pineal region tumors","volume":"134","author":"Bruce","year":"1995"},{"key":"b4-jns1251","series-title":"J Neurosurg","first-page":"319","article-title":"Tumor control after surgery and radiotherapy for pineocytoma. Clinical article","volume":"113","author":"Clark","year":"2010"},{"key":"b5-jns1251","series-title":"Neurosurg Clin N Am","first-page":"403","article-title":"Contemporary management of pineocytoma","volume":"22","author":"Clark","year":"2011"},{"key":"b6-jns1251","series-title":"J Neurooncol","first-page":"255","article-title":"Factors influencing overall survival rates for patients with pineocytoma","volume":"100","author":"Clark","year":"2010"},{"issue":"3","key":"b7-jns1251","series-title":"Neurosurgery","first-page":"89","article-title":"Supracerebellar infratentorial approach to cavernous malformations of the brainstem: surgical variants and clinical experience with 45 patients","volume":"66","author":"de Oliveira","year":"2010"},{"key":"b8-jns1251","series-title":"Neurosurgery","first-page":"349","article-title":"Diagnosis and management of pineocytomas","volume":"55","author":"Deshmukh","year":"2004"},{"key":"b9-jns1251","series-title":"Neurosurgery","first-page":"880","article-title":"The role of radiosurgery for the treatment of pineal parenchymal tumors","volume":"51","author":"Hasegawa","year":"2002"},{"key":"b10-jns1251","series-title":"Prog Neurol Surg","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1159\/000210052","article-title":"Role of stereotactic radiosurgery in the management of pineal parenchymal tumors","volume":"23","author":"Kano","year":"2009"},{"key":"b11-jns1251","series-title":"J Neurooncol","first-page":"301","article-title":"Stereotactic gamma radiosurgery for pineal and related tumors","volume":"54","author":"Kobayashi","year":"2001"},{"key":"b12-jns1251","series-title":"Surg Neurol","first-page":"250","article-title":"Principles of treatment of the pineal region tumors","volume":"59","author":"Konovalov","year":"2003"},{"issue":"6","key":"b13-jns1251","series-title":"Neurosurg Focus","first-page":"E12","article-title":"Role of Gamma Knife surgery in the management of pineal region tumors","volume":"23","author":"Lekovic","year":"2007"},{"key":"b14-jns1251","series-title":"Prog Neurol Surg","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1159\/000210057","article-title":"Stereotactic radiosurgery for pineal and related tumors","volume":"23","author":"Mori","year":"2009"},{"key":"b15-jns1251","series-title":"Neurosurgery","first-page":"907","article-title":"Pineal region tumors and the role of stereotactic biopsy: review of the mortality, morbidity, and diagnostic rates in 370 cases","volume":"39","author":"Regis","year":"1996"},{"key":"b16-jns1251","series-title":"Acta Neurochir (Wien)","first-page":"5","article-title":"The role of Gamma Knife radiosurgery in the treatment of pineal parenchymal tumours","volume":"148","author":"Reyns","year":"2006"},{"key":"b17-jns1251","series-title":"Radiat Oncol","first-page":"122","article-title":"Long term outcome of adolescent and adult patients with pineal parenchymal tumors treated with fractionated radiotherapy between 1982 and 2003\u2014a single institution's experience","volume":"5","author":"Stoiber","year":"2010"}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/117\/2\/article-p212.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/117\/2\/article-p212.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/117\/2\/article-p212.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T23:24:28Z","timestamp":1679873068000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/117\/2\/article-p212.xml"}},"subtitle":["Clinical article"],"short-title":[],"issued":{"date-parts":[[2012,8]]},"references-count":17,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2012.5.jns1251","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,8]]}}}