P01.166 Survival with pineal region tumours - Is the outlook changing?. (19th September 2018)

• Record Type: Journal Article
• Authors: Nanda, P; Duffin, J; Kane, P; Varma, A
• Is Part Of: Neuro-oncology. Volume 20(2018)Supplement 3
• Page Start: iii271
• Page End: iii271
• Publication Date: 2018-09-19
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noy139.208
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: Background: Tumours in the pineal region is a rare entity and in general considered to have a poor outcome. We analysed a series of patients with pineal region tumours and found them to have on an average a longer life expectancy and a lesser rate of recurrence as compared to patients with cerebral tumours outwith pineal region. Material and Methods: Retrospective study of 13 patients with histologically proven pineal tumours treated in our neurosurgical unit between 2002 and 2017. Data were collected from case notes, histopathology reports, clinic letters, MDT outcomes and from oncology department. Results: Thirteen patients with pineal tumours treated in our unit since 2002 had tumours representing all possible differentiations/grading. There were two patients with pineal glioblastomas (Gr IV), two with pineoblastoma (Gr IV), three patients with pineal parenchymal tumours of intermediate differentiation (Gr II or III), two astrocytomas (Gr II and III), two pineal germinomas (Gr I), one pineocytoma and one pineal papillary neuroepithelial tumour. Majority of these (10/14) had biopsy whereas four underwent debulking of pineal tumour but all of them received radiochemotherapy after surgical procedure and four had subsequent adjuvant chemotherapy. Two patients did not survive but the remaining have had long term survival since diagnosis. Even importantly three of the four patients diagnosed with high grade pineal tumours (GBM and pineoblastoma) have had better outcome amongst the cohort. Conclusion: In this analysis, most of the patients had reasonably good outcome, especially patients with high grade pineal tumours. The two pineal glioblastomas are surviving with good performance status and radiological evidence of no recurrence at 78 months and 56 months from the time of diagnosis. Is this a result of advanced targeted radiochemotherapy or due to the anatomic location of pineal gland which makes the tumours sensitive to treatment or perhaps pineal region tumours are encapsulated and do not disseminate via white matter channels. This needs further research. We appreciate that with a study involving a small number of patients, we cannot generalise the outcome in all pineal tumours but we would like to run a multicentral research to look into the peculiar outcome of pineal tumours.