Prognosis of Pineal Region Tumors in Children: A Population-Based Study.

Background: This study aims to evaluate the prognostic factors and survival outcomes of pediatric patients with pineal region tumors (PRTs) using a large population-based registry.

Methods: We employed a retrospective cohort design, utilizing data from the Surveillance, Epidemiology, and End Results program, covering the period from 2000 to 2019. We included pediatric patients (ages 0-18) with histologically verified malignant PRTs. To determine prognostic indicators, we conducted survival analyses using Kaplan-Meier methods and Cox proportional hazards models. Furthermore, we constructed a predictive nomogram derived from the Cox regression outcomes.

Results: The study included 596 pediatric patients with PRTs. Germ cell tumors were the most common subtype (63.3%), followed by pineoblastomas (26.3%) and other subtypes (10.4%). The overall 5-year survival rate was 79.6%. Multivariate analysis revealed that age at diagnosis, Surveillance, Epidemiology, and End Results stage, histological subtypes, and radiation therapy were significant predictors of survival. Patients under 5 years of age and those diagnosed with pineoblastomas had worse survival outcomes. Radiation therapy was associated with improved survival.

Conclusions: Early age at diagnosis and aggressive histological types such as pineoblastomas are associated with poorer outcomes. Future research should focus on refining therapeutic protocols that integrate the histological and molecular profiles of these tumors.