Journal of neuro-oncology · 2025
Surgical characteristics and survival outcomes of pediatric pineal region tumors: a cohort study in Vietnam.
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Can Dang Do Thanh, Giang Nguyen Doan Hoang, Van Nguyen Do, Tuan Pham Anh
Аннотация
PURPOSE: This study aims to assess the surgical characteristics and prognostic factors for survival outcomes of pineal region tumors (PRTs).
METHODS: This was a retrospective cohort study for pediatric PRTs undergoing tumor resection at Children's Hospital 2 between 2017 and 2023. Modified Rankin Scale (mRS) and Kaplan-Meier estimation were used for analyzing functional and survival outcomes.
RESULTS: A total of 50 PRT patients were included with a median follow-up (FU) time of 34.5 months (interquartile range [IQR] 16-54.3). Histopathologies included 28% mature teratomas, 22% malignant non-germinomatous germ cell tumors (NGGCTs), 28% pineal parenchymal tumors (PPTs), and 22% gliomas. Gross-total resection (GTR) was achieved in 100% of mature teratomas compared to only 45.5% of gliomas (p = 0.02). Favorable functional outcome was 84% at 3-month and 66% at final FU. Progression-free survival (PFS) was 78% at 1 year and 54% at 5 years. Overall survival (OS) was 86% at 1 year and 76% at 5 years. Histopathology and permanent morbidity significantly influenced survival outcomes (PFS, p < 0.001; OS, p = 0.03; p < 0.001), while the extent of resection (EOR) had no substantial impact on these (PFS, p = 0.45; OS, p = 0.46).
CONCLUSIONS: Surgical resection plays a crucial role in certain pediatric PRTs with acceptable morbidity and mortality. A higher GTR rate can be achieved in benign lesions, particularly in mature teratomas. Functional outcome improves favorably but declines thereafter due to the progression of malignant diseases. Prognostic factors for survival outcomes include histopathology and permanent morbidity regardless of EOR.
METHODS: This was a retrospective cohort study for pediatric PRTs undergoing tumor resection at Children's Hospital 2 between 2017 and 2023. Modified Rankin Scale (mRS) and Kaplan-Meier estimation were used for analyzing functional and survival outcomes.
RESULTS: A total of 50 PRT patients were included with a median follow-up (FU) time of 34.5 months (interquartile range [IQR] 16-54.3). Histopathologies included 28% mature teratomas, 22% malignant non-germinomatous germ cell tumors (NGGCTs), 28% pineal parenchymal tumors (PPTs), and 22% gliomas. Gross-total resection (GTR) was achieved in 100% of mature teratomas compared to only 45.5% of gliomas (p = 0.02). Favorable functional outcome was 84% at 3-month and 66% at final FU. Progression-free survival (PFS) was 78% at 1 year and 54% at 5 years. Overall survival (OS) was 86% at 1 year and 76% at 5 years. Histopathology and permanent morbidity significantly influenced survival outcomes (PFS, p < 0.001; OS, p = 0.03; p < 0.001), while the extent of resection (EOR) had no substantial impact on these (PFS, p = 0.45; OS, p = 0.46).
CONCLUSIONS: Surgical resection plays a crucial role in certain pediatric PRTs with acceptable morbidity and mortality. A higher GTR rate can be achieved in benign lesions, particularly in mature teratomas. Functional outcome improves favorably but declines thereafter due to the progression of malignant diseases. Prognostic factors for survival outcomes include histopathology and permanent morbidity regardless of EOR.