{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:02:50Z","timestamp":1787025770550,"version":"build-2736575974"},"reference-count":35,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","license":[{"start":{"date-parts":[[2023,8,1]],"date-time":"2023-08-01T00:00:00Z","timestamp":1690848000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Pineal region tumors account for 2.7%\u201311% of all CNS tumors in children. In this series, the authors present their surgical results and long-term outcomes from a pediatric pineal region tumor cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A total of 151 children aged 0\u201318 years were treated from 1991 to 2020. Tumor markers were collected in all patients; if positive, chemotherapy was performed, and if negative, biopsy was performed, preferably endoscopically. Resection was performed when there was a residual germ cell tumor (GCT) lesion after chemotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The distribution based on histological type, as verified by markers, biopsy, or surgery, was germinoma (33.1%), nongerminomatous GCT (NGGCT) (27.2%), pineoblastoma (22.5%), glioma (12.6%), and embryonal tumor (atypical teratoid rhabdoid tumor) (3.3%). A total of 97 patients underwent resection, and gross-total resection (GTR) was achieved in 64%; the highest GTR rate (76.6%) was found in patients with GCTs, and the lowest (30.8%) was found in those with gliomas. The supracerebellar infratentorial approach (SCITA) was the most common, performed in 53.6% of patients, followed by the occipital transtentorial approach (OTA), performed in 24.7% of patients. Lesions were biopsied in 70 patients, and the diagnostic accuracy was 91.4. The overall survival (OS) rates at 12, 24, and 60 months as stratified by histological type were 93.7%, 93.7%, and 88% for patients with germinomas; 84.5%, 63.5%, and 40.7% for patients with pineoblastomas; 89.4%, 80.8%, and 67.2% for patients with NGGCTs; 89.4%, 78.2%, and 72.6% for patients with gliomas; and 40%, 20%, and 0% for patients with embryonal tumors, respectively (p &lt; 0001). The OS at 60 months was significantly higher in the group with GTR (69.7%) than in the group with subtotal resection (40.8%) (p = 0.04). The 5-year progression-free survival was 77% for patients with germinomas, 72.6% for patients with gliomas, 50.8% for patients with NGGCTs, and 38.9% for patients with pineoblastomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The efficacy of resection varies by histological type, and complete resection is associated with higher OS rates. Endoscopic biopsy is the method of choice for patients presenting with negative tumor markers and hydrocephalus. For tumors restricted to the midline and with extension to the third ventricle, a SCITA is preferred, whereas for lesions with extension toward the fourth ventricle, an OTA is preferred.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2023.3.peds22468","type":"journal-article","created":{"date-parts":[[2023,5,6]],"date-time":"2023-05-06T13:00:13Z","timestamp":1683378013000},"page":"184-193","source":"Crossref","is-referenced-by-count":23,"title":["Outcomes and surgical approaches for pineal region tumors in children: 30 years\u2019 experience"],"prefix":"10.3171","volume":"32","author":[{"given":"Sergio","family":"Cavalheiro","sequence":"first","affiliation":[{"name":"Department of Neurology and Neurosurgery, Federal University of S\u00e3o Paulo;"},{"name":"Division of Neurosurgery, Institute of Pediatric Oncology (IOP\/GRAACC); and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linoel Curado","family":"Valsechi","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Federal University of S\u00e3o Paulo;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia Alessandra","family":"Dastoli","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Federal University of S\u00e3o Paulo;"},{"name":"Division of Neurosurgery, Institute of Pediatric Oncology (IOP\/GRAACC); and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jardel Mendon\u00e7a","family":"Nic\u00e1cio","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Federal University of S\u00e3o Paulo;"},{"name":"Division of Neurosurgery, Institute of Pediatric Oncology (IOP\/GRAACC); and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Maria","family":"Cappellano","sequence":"additional","affiliation":[{"name":"Division of Neuro-Oncology, Institute of Pediatric Oncology (IOP\/GRAACC), S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasjla","family":"Saba da Silva","sequence":"additional","affiliation":[{"name":"Division of Neuro-Oncology, Institute of Pediatric Oncology (IOP\/GRAACC), S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos Devanir","family":"Silva da Costa","sequence":"additional","affiliation":[{"name":"Department of Neurology and Neurosurgery, Federal University of S\u00e3o Paulo;"},{"name":"Division of Neurosurgery, Institute of Pediatric Oncology (IOP\/GRAACC); and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3 suppl","key":"b1","series-title":"Neurosurgery","first-page":"S131","article-title":"Tentorial incisura","volume":"47","author":"Rhoton AL Jr","year":"2000","unstructured":"Rhoton AL Jr. Tentorial incisura. 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