{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:15:13Z","timestamp":1785413713120,"version":"3.56.0"},"reference-count":69,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T00:00:00Z","timestamp":1658361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background: CNS germinoma, being marker-negative, are mainly diagnosed by histological examination. These tumors predominantly appear in the suprasellar and\/or pineal region. In contrast to the suprasellar region, where biopsy is the standard procedure in case of a suspected germ-cell tumor to avoid mutilation to the endocrine structures, pineal tumors are more accessible to primary resection. We evaluated the perioperative course of patients with pineal germinoma who were diagnosed by primary biopsy or resection in the SIOP CNS GCT 96 trial. Methods: Overall, 235 patients had germinoma, with pineal localization in 113. The relationship between initial symptoms, tumor size, and postoperative complications was analyzed. Results: Of 111 evaluable patients, initial symptoms were headache (n = 98), hydrocephalus (n = 93), double vision (n = 62), Parinaud syndrome (n = 57), and papilledema (n = 44). There was no significant relationship between tumor size and primary symptoms. A total of 57 patients underwent primary resection and 54 underwent biopsy. Postoperative complications were reported in 43.2% of patients after resection and in 11.4% after biopsy (p &lt; 0.008). Biopsy was significantly more commonly performed on larger tumors (p= 0.002). Conclusions: These results support the practice of biopsy over resection for histological confirmation of pineal germinoma.<\/jats:p>","DOI":"10.3390\/cancers14143555","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T22:38:50Z","timestamp":1658443130000},"page":"3555","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of the Perioperative and Postoperative Course of Surgery for Pineal Germinoma in the SIOP CNS GCT 96 Trial"],"prefix":"10.3390","volume":"14","author":[{"given":"Ehab","family":"Shabo","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Rheinische Friedrich-Wilhelms-University, Sigmund-Freud-Stra\u00dfe 25, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8112-2795","authenticated-orcid":false,"given":"Thomas","family":"Czech","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9494-0199","authenticated-orcid":false,"given":"James C.","family":"Nicholson","sequence":"additional","affiliation":[{"name":"Department of Paediatric Haematology and Oncology, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Conor","family":"Mallucci","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Alder Hey Children\u2019s Hospital, Liverpool L14 5AB, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine","family":"Mottolese","sequence":"additional","affiliation":[{"name":"Neurochirurgie P\u00e9diatrique, H\u00f4pital Femme-M\u00e8re-Enfant, Universit\u00e9 de Lyon, 59, Boulevard Pinel, 69003 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluca","family":"Piatelli","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosciences, Giannina Gaslini Children\u2019s Hospital, 16147 Genvoa, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Didier","family":"Frappaz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Institut d\u2019H\u00e9matologie et d\u2019Oncologie P\u00e9diatrique, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4480-1147","authenticated-orcid":false,"given":"Matthew Jonathan","family":"Murray","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Alder Hey Children\u2019s Hospital, Liverpool L14 5AB, UK"},{"name":"Department of Pathology, University of Cambridge, Tennis Court Road, Cambridge CB2 1QP, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecile","family":"Faure-Conter","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, Institut d\u2019H\u00e9matologie et d\u2019Oncologie P\u00e9diatrique, 69008 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Luisa","family":"Garr\u00e8","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sevgi","family":"Sarikaya-Seiwert","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, Department of Neurosurgery, Rheinische, Friedrich-Wilhelms-University, Sigmund-Freud-Stra\u00dfe 25, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9194-9427","authenticated-orcid":false,"given":"Leonie","family":"Weinhold","sequence":"additional","affiliation":[{"name":"Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannes","family":"Haberl","sequence":"additional","affiliation":[{"name":"Section of Pediatric Neurosurgery, Department of Neurosurgery, Rheinische, Friedrich-Wilhelms-University, Sigmund-Freud-Stra\u00dfe 25, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7893-7982","authenticated-orcid":false,"given":"Gabriele","family":"Calaminus","sequence":"additional","affiliation":[{"name":"Department of Pediatric Hematology and Oncology, University Hospital Bonn, Venusberg-Campus 1, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,7,21]]},"reference":[{"key":"ref_1","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":"Fangusaro","year":"2008","journal-title":"Oncologist"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1007\/s11060-019-03173-4","article-title":"Descriptive epidemiology of germ cell tumors of the central nervous system diagnosed in the United States from 2006 to 2015","volume":"143","author":"Gittleman","year":"2019","journal-title":"J. Neuro-Oncol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3171\/jns.1985.63.2.0155","article-title":"Intracranial germ-cell tumors: Natural history and pathogenesis","volume":"63","author":"Jennings","year":"1985","journal-title":"J. Neurosurg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"545","DOI":"10.3171\/jns.1991.74.4.0545","article-title":"Intracranial germ-cell tumors in children","volume":"74","author":"Hoffman","year":"1991","journal-title":"J. Neurosurg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s002340050634","article-title":"MRI of germinomas arising from the basal ganglia and thalamus","volume":"40","author":"Kim","year":"1998","journal-title":"Neuroradiology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1007\/BF00262257","article-title":"Germ cell tumors of the thalamus and the basal ganglia","volume":"6","author":"Tamaki","year":"1990","journal-title":"Child\u2019s Nerv. Syst."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s11060-009-9881-9","article-title":"Pineal gland tumors: Experience from the SEER database","volume":"94","author":"Sultan","year":"2009","journal-title":"J. Neuro-Oncol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1002\/1097-0142(19880601)61:11<2148::AID-CNCR2820611103>3.0.CO;2-Q","article-title":"Primary central nervous system germ cell tumors. Effect of histologic confirmation on radiotherapy","volume":"61","author":"Kersh","year":"1988","journal-title":"Cancer"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.pcl.2007.10.010","article-title":"Central Nervous System Tumors","volume":"55","author":"Packer","year":"2008","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1023\/A:1012721723387","article-title":"Pathology of pineal region tumors","volume":"54","author":"Hirato","year":"2001","journal-title":"J. Neuro-Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.prp.2005.11.006","article-title":"Histological analysis of lesions of the pineal region: A retrospective study of 12 years","volume":"202","author":"Kumar","year":"2006","journal-title":"Pathol. Res. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2585","DOI":"10.1200\/JCO.1999.17.8.2585","article-title":"Radiation Therapy for Intracranial Germinoma: Results of the German Cooperative Prospective Trials MAKEI 83\/86\/89","volume":"17","author":"Bamberg","year":"1999","journal-title":"J. Clin. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1002\/mpo.10285","article-title":"Germ cell tumours of the central nervous system in children\u2014controversies in radiotherapy","volume":"40","author":"Borg","year":"2003","journal-title":"Med. Pediatr. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1016\/S0360-3016(97)00135-1","article-title":"Radiation therapy for histologically confirmed primary central nervous system germinoma","volume":"38","author":"Haddock","year":"1997","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"419","DOI":"10.1016\/S0360-3016(97)00330-1","article-title":"Intracranial germinoma: The case for lower dose radiation therapy","volume":"39","author":"Hardenbergh","year":"1997","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1016\/0360-3016(95)00067-9","article-title":"Radiation therapy for primary intracranial germ-cell tumors","volume":"32","author":"Wolden","year":"1995","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/S0959-8049(97)10045-4","article-title":"Germ cell tumours of the central nervous system: Treatment consideration based on 111 cases and their long-term clinical outcomes","volume":"34","author":"Sawamura","year":"1998","journal-title":"Eur. J. Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1016\/j.ijrobp.2009.06.077","article-title":"Long-Term Follow-Up of Dose-Adapted and Reduced-Field Radiotherapy with or without Chemotherapy for Central Nervous System Germinoma","volume":"77","author":"Jensen","year":"2010","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1016\/S0360-3016(02)04611-4","article-title":"Radiation therapy for intracranial germ cell tumors","volume":"56","author":"Missett","year":"2003","journal-title":"Int. J. Radiat. Oncol. Biol. Phys."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1002\/1097-0142(19940801)74:3<940::AID-CNCR2820740323>3.0.CO;2-U","article-title":"A phase II trial of preirradiation carboplatin in newly diagnosed germinoma of the central nervous system","volume":"74","author":"Allen","year":"1994","journal-title":"Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3171\/jns.1987.67.1.0065","article-title":"Neoadjuvant chemotherapy for newly diagnosed germ-cell tumors of the central nervous system","volume":"67","author":"Allen","year":"1987","journal-title":"J. Neurosurg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1200\/JCO.1999.17.3.933","article-title":"Phase II Trial of Primary Chemotherapy Followed by Reduced-Dose Radiation for CNS Germ Cell Tumors","volume":"17","author":"Buckner","year":"1999","journal-title":"J. Clin. Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1007\/s003810050279","article-title":"Comparison of survival outcomes in patients with intracranial germinomas treated with radiation alone versus reduced-dose radiation and chemotherapy","volume":"14","author":"Fouladi","year":"1998","journal-title":"Child\u2019s Nerv. Syst."},{"key":"ref_24","first-page":"36","article-title":"Cisplatin-Based Chemotherapy Followed By Focal, Reduced-Dose Irradiation For Pediatric Primary Central Nervous System Germinomas","volume":"28","author":"Douglas","year":"2006","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1002\/pbc.20815","article-title":"Pre-radiation chemotherapy with response-based radiation therapy in children with central nervous system germ cell tumors: A report from the Children\u2019s Oncology Group","volume":"48","author":"Kretschmar","year":"2007","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1002\/pbc.22468","article-title":"Treatment of primary CNS germinomatous germ cell tumors with chemotherapy prior to reduced dose whole ventricular and local boost irradiation","volume":"55","author":"Khatua","year":"2010","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1097\/00006123-199608000-00010","article-title":"Stereotactic management of lesions of the pineal region","volume":"39","author":"Kreth","year":"1996","journal-title":"Neurosurgery"},{"key":"ref_28","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","journal-title":"Neurosurgery"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1016\/S0025-6196(12)62268-X","article-title":"Stereotactic procedures for lesions of the pineal region","volume":"68","author":"Popovic","year":"1993","journal-title":"Mayo Clin. Proc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S1042-3680(18)30692-2","article-title":"Stereotactic radiosurgery for pineal region tumors","volume":"3","author":"Dempsey","year":"1992","journal-title":"Neurosurg. Clin. N. Am."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"965","DOI":"10.1227\/00006123-198805000-00032","article-title":"The Lumbar Spine and Back Pain","volume":"22","author":"Clark","year":"1988","journal-title":"Neurosurgery"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/j.neuchi.2010.05.006","article-title":"Stereotactic robot-guided biopsies of brain stem lesions: Experience with 15 cases","volume":"56","author":"Haegelen","year":"2010","journal-title":"Neurochirurgie"},{"key":"ref_33","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."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"689","DOI":"10.3171\/jns.1988.68.5.0689","article-title":"Pineal region tumors in children","volume":"68","author":"Edwards","year":"1988","journal-title":"J. Neurosurg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"446","DOI":"10.3171\/jns.1997.86.3.0446","article-title":"Primary intracranial germ cell tumors: A clinical analysis of 153 histologically verified cases","volume":"86","author":"Matsutani","year":"1997","journal-title":"J. Neurosurg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"262","DOI":"10.3171\/jns.1997.87.2.0262","article-title":"Management of primary intracranial germinomas: Diagnostic surgery or radical resection?","volume":"87","author":"Sawamura","year":"1997","journal-title":"J. Neurosurg."},{"key":"ref_37","first-page":"243","article-title":"Central nervous system germ cell tumors","volume":"25","author":"Balmaceda","year":"1998","journal-title":"Semin. Oncol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1227\/00006123-199403000-00021","article-title":"Treatment of nongerminomatous germ-cell tumors of the pineal region","volume":"34","author":"Herrmann","year":"1994","journal-title":"Neurosurgery"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1215\/S1152851703000243","article-title":"Refining the staging evaluation of pineal region germinoma using neuroendoscopy and the presence of preoperative diabetes insipidus","volume":"6","author":"Reddy","year":"2004","journal-title":"Neuro Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1007\/s10143-020-01323-1","article-title":"Management of pineal region tumors in a pediatric case series","volume":"44","author":"Schulz","year":"2020","journal-title":"Neurosurg. Rev."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/s00381-012-1954-y","article-title":"Surgical pathway and management of pineal region tumours in children","volume":"29","author":"Pettorini","year":"2013","journal-title":"Childs Nerv. Syst."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"S18.e9","DOI":"10.1016\/j.wneu.2012.02.020","article-title":"Pineal region tumors: Simultaneous endoscopic third ventriculostomy and tumor biopsy","volume":"79","author":"Morgenstern","year":"2013","journal-title":"World Neurosurg."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1093\/neuonc\/not019","article-title":"SIOP CNS GCT 96: Final report of outcome of a prospective, multinational nonrandomized trial for children and adults with intracranial germinoma, comparing craniospinal irradiation alone with chemotherapy followed by focal primary site irradiation for patients with localized disease","volume":"15","author":"Calaminus","year":"2013","journal-title":"Neuro Oncol."},{"key":"ref_44","first-page":"384","article-title":"Shunting and irradiation of pineal tumors","volume":"32","author":"Marsh","year":"1985","journal-title":"Clin. Neurosurg."},{"key":"ref_45","first-page":"509","article-title":"Surgical management of pineal region tumors (honored guest lecture)","volume":"39","author":"Stein","year":"1992","journal-title":"Clin. Neurosurg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1159\/000413684","article-title":"Direct surgery for pineal tumors: Occipital-transtentorial approach","volume":"30","author":"Lapras","year":"1987","journal-title":"Prog. Exp. Tumor Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1007\/978-3-7091-8813-2_20","article-title":"Surgery of pineal region lesions in childhood","volume":"35","author":"Pendl","year":"1985","journal-title":"Acta Neurochir. Suppl."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1007\/BF01540866","article-title":"Treatment of tumours of the pineal region and posterior part of the third ventricle","volume":"116","author":"Herrmann","year":"1992","journal-title":"Acta Neurochir."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1016\/S0090-3019(03)00080-6","article-title":"Principles of treatment of the pineal region tumors","volume":"59","author":"Konovalov","year":"2003","journal-title":"Surg. Neurol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1016\/j.wneu.2016.03.088","article-title":"Endoscopic Versus Stereotactic Procedure for Pineal Tumor Biopsies: Focus on Overall Efficacy Rate","volume":"92","author":"Balossier","year":"2016","journal-title":"World Neurosurg."},{"key":"ref_51","first-page":"287","article-title":"Contribution of stereotactic methods to diagnosis and treatment of tumors of the pineal region (author\u2019s transl)","volume":"134","author":"Pecker","year":"1978","journal-title":"Rev. Neurol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.neuchi.2014.06.002","article-title":"Endoscopic versus stereotactic procedure for pineal tumour biopsies: Comparative review of the literature and learning from a 25-year experience","volume":"61","author":"Balossier","year":"2015","journal-title":"Neurochirurgie"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1080\/02688690120072441","article-title":"The role of endoscopic biopsy and third ventriculostomy in the management of pineal region tumours","volume":"15","author":"Pople","year":"2001","journal-title":"Br. J. Neurosurg."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"245","DOI":"10.3171\/jns.2000.93.2.0245","article-title":"Efficacy of neuroendoscopic procedures in minimally invasive preferential management of pineal region tumors: A prospective study","volume":"93","author":"Oi","year":"2000","journal-title":"J. Neurosurg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"704","DOI":"10.3171\/2013.3.PEDS12416","article-title":"Safety and diagnostic accuracy of neuroendoscopic biopsies: An international multicenter study","volume":"11","author":"Constantini","year":"2013","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.3171\/2011.7.JNS101976","article-title":"Nationwide investigation of the current status of therapeutic neuroendoscopy for ventricular and paraventricular tumors in Japan","volume":"115","author":"Hayashi","year":"2011","journal-title":"J. Neurosurg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3171\/jns.1973.38.2.0251","article-title":"Ventriculofiberscope: A new technique for endoscopic diagnosis and operation. Technical note","volume":"38","author":"Fukushima","year":"1973","journal-title":"J. Neurosurg."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1227\/00006123-197803000-00006","article-title":"Endoscopic biopsy of intraventricular tumors with the use of a ventriculofiberscope","volume":"2","author":"Fukushima","year":"1978","journal-title":"Neurosurgery"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.wneu.2014.11.013","article-title":"Endoscopic biopsy and third ventriculostomy for the management of pineal region tumors","volume":"83","author":"Ahmed","year":"2015","journal-title":"World Neurosurg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"28","DOI":"10.3171\/2017.7.JNS17260","article-title":"Quality of life following surgical treatment of lesions within the pineal region","volume":"130","author":"Fedorko","year":"2018","journal-title":"J. Neurosurg."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1007\/s11060-016-2138-5","article-title":"Microsurgical resection of pineal region tumors","volume":"130","author":"Sonabend","year":"2016","journal-title":"J. Neurooncol."},{"key":"ref_62","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":"ref_63","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1093\/ons\/opx038","article-title":"A Single-Institution Experience with Pineal Region Tumors: 50 Tumors Over 1 Decade","volume":"13","author":"Abecassis","year":"2017","journal-title":"Oper. Neurosurg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1055\/s-0038-1675231","article-title":"Supratentorial and Infratentorial Approaches to Pineal Surgery: A Database Analysis","volume":"80","author":"Rosenberg","year":"2019","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1007\/s00701-014-2224-4","article-title":"Radical resection of nongerminomatous pineal region tumors via the occipital transtentorial approach based on arachnoidal consideration: Experience on a series of 143 patients","volume":"156","author":"Qi","year":"2014","journal-title":"Acta Neurochir."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1007\/s003810050175","article-title":"Pineal tumors: Experience with 48 cases over 10 years","volume":"14","author":"Cho","year":"1998","journal-title":"Childs Nerv. Syst."},{"key":"ref_67","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":"ref_68","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1007\/s11060-021-03919-z","article-title":"Long term outcomes following surgery for pineal region tumors","volume":"156","author":"Shepard","year":"2022","journal-title":"J. Neurooncol."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1565","DOI":"10.1093\/neuonc\/noz139","article-title":"Integrated clinical, histopathological, and molecular data analysis of 190 central nervous system germ cell tumors from the iGCT Consortium","volume":"21","author":"Takami","year":"2019","journal-title":"Neuro Oncol."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/14\/3555\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:55:56Z","timestamp":1760140556000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/14\/14\/3555"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,21]]},"references-count":69,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["cancers14143555"],"URL":"https:\/\/doi.org\/10.3390\/cancers14143555","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,21]]}}}