LAUSR

BACKGROUND Pineal region tumors represent challenging surgical lesions with wide ranges of survival rates reported in different surgical series. Here, we emphasize the role of the complete microsurgical resection (CMR) in order to obtain a favorable long-term outcome of pineal region tumors. METHODS We report a retrospective study of pineal region tumors operated in Helsinki Neurosurgery between 1997 and 2015. Information was obtained from the hospital records, and an evaluation of the Finnish population register was conducted in July 2018 to determine the current status of the patients. RESULTS ; 76 pineal region tumors were operated. The survival rate was 62 % at a mean follow up of 125±105 (0-588) months, and the disease-related mortality was limited to 14 (18.4%) patients. Up to July 2018, twenty-nine patients had died. 2 patients died 1 and 3 months after surgery with delayed thalamic infarctions, 12 patients with disease progression, and 15 had non disease-related deaths. Only one patient was lost in the long-term FU. 10/14 disease-related deaths occurred during the first 5 years of follow up: 5 diffuse gliomas, 3 germ cell tumors, 1 Grade II-III PPTID, and 1 meningioma. CMR was linked to better tumor free survival and long-term survival rates with exception of diffuse gliomas. CONCLUSION CMR, in the setting of a multidisciplinary management of pineal region tumors, correlates with favorable survival rates and with minimal mortality. Surgically treated grade II-IV gliomas conform a particular group with high mortality within the first 5 years independently of the microsurgical resection.