Introduction: Pineal lesions are rare and surgically challenging due to their deep location, histological diversity, and potential malignancy. The complexity of the pineal region anatomy and the diverse pathological spectrum contribute to the lack of standardized treatment strategies, making appropriate management controversial. Aim: This study aimed to evaluate the surgical outcomes of patients with pineal tumors or cysts and to assess the impact of different surgical approaches, particularly the extent of resection, on progression-free survival. Methods: We conducted a retrospective analysis of 27 patients treated for pineal tumors or cysts at our institution between 2010 and 2020. Data regarding clinical presentation, surgical technique, extent of resection, pathological diagnosis, and follow-up outcomes were collected and analyzed. Surgical outcomes were compared between patients undergoing biopsy and those receiving varying degrees of tumor resection. Results: Our analyses suggest that total resection could be the most effective approach for reducing the risk of tumor recurrence. Furthermore, our findings indicate that histological subtype is a statistically significant predictor of progression-free survival in patients. Conclusion: Our findings suggest that achieving a greater extent of resection, when safely feasible, may contribute to improved long-term outcomes. These results emphasize the need for larger, multicenter studies to further optimize treatment strategies for these complex lesions
Contreras et al. (Wed,) studied this question.