title: Treatment Results for Pineal Region Tumors: Role of Stereotactic Biopsy Plus Adjuvant Therapy vs. Open Resection.
abstract: OBJECTIVE
  Pineal tumors represent uncommon intracranial tumors with highly diverse histologic subtypes. There still exists a controversy in literature about what influences overall survival and outcome.
  
  
  METHODS
  We present the results of 48 patients with pineal tumor treated either by stereotactic biopsy followed by adjuvant therapy (23 patients) or open surgical resection without (18 patients) or with (7 patients) adjuvant therapy in Shohada Tajrish Hospital, Iran (1993-2008).
  
  
  RESULTS
  Unremarkable pathology yield was 3/23 in the biopsy and 1/25 in the surgical group. Perioperative mortality and morbidity were 4.3% and 0% in the biopsy group and 32.0% and 4.0% in the surgical group. Analysis showed that age, gender, cranial nerve deficit, motor deficit, preoperative Karnofsky Performance Score (KPS), midbrain involvement, and brain stem involvement had no effect on neither perioperative mortality nor long-term survival, while local invasion and pineocytoma pathology increased perioperative mortality and presence of hydrocephalus and pineoblastoma pathology significantly decreased long-term survival. Hospitalization length was shorter in the stereotactic biopsy plus adjuvant therapy group.
  
  
  CONCLUSIONS
  The results of the study suggests that although gross total resection is the standard of care in most pineal tumors nowadays, stereotactic biopsy followed by adjuvant therapy may still be a safe and viable option.
authors.affiliation: Shahid Beheshti University of Medical Sciences, Shohada Tajrish Hospital, Department of Neurosurgery, Tehran, Iran.
authors.forename: Rouzbeh
authors.initials: R
authors.lastname: Motiei-Langroudi
authors.forename: Homa
authors.initials: H
authors.lastname: Sadeghian
authors.forename: Mohammad Mehdi
authors.initials: MM
authors.lastname: Soleimani
authors.forename: Amir Saied
authors.initials: AS
authors.lastname: Seddighi
authors.forename: Sohrab
authors.initials: S
authors.lastname: Shahzadi
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy / Q000379:methods*; D001932:Brain Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D004358:Drug Therapy; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D010871:Pinealoma / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy / Q000601:surgery*; D011878:Radiotherapy; D012307:Risk Factors; D013238:Stereotaxic Techniques; D016896:Treatment Outcome