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Related Experiment Video

Updated: Aug 27, 2025

Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy
03:13

Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy

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Second-look surgery for pineal region tumors.

Hideki Ogiwara1

  • 1Division of Neurosurgery, National Center for Child Health and Development, Okura 2-10-1, Setagaya-ku, Tokyo, 157-8535, Japan. hideki_o@d5.dion.ne.jp.

Child'S Nervous System : Chns : Official Journal of the International Society for Pediatric Neurosurgery
|October 1, 2022
PubMed
Summary

Neoadjuvant chemotherapy followed by second-look surgery effectively reduced pediatric pineal region tumor volume and vascularity. This approach facilitated maximal safe tumor resection with no observed complications and positive long-term outcomes.

Keywords:
Neoadjuvant chemotherapyPineal region tumorsSecond-look surgery

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Area of Science:

  • Pediatric neurosurgery
  • Neuro-oncology
  • Surgical oncology

Background:

  • Pineal region tumors pose significant surgical challenges due to their location near critical neurovascular structures.
  • Traditional surgical approaches often involve narrow corridors, limiting resection extent and increasing risks, especially for large or hypervascular tumors.

Purpose of the Study:

  • To evaluate the effectiveness of neoadjuvant chemotherapy combined with second-look surgery for achieving maximal safe resection of pediatric pineal region tumors.
  • To assess the impact of this combined approach on tumor volume, vascularity, and patient outcomes.

Main Methods:

  • Retrospective review of pediatric patients with pineal region tumors who underwent neoadjuvant chemotherapy and subsequent second-look surgery.
  • Analysis of tumor histopathology, response to chemotherapy, surgical approach, resection extent, and postoperative outcomes.

Main Results:

  • Neoadjuvant chemotherapy significantly reduced tumor volume in 89% of patients, facilitating safer resection.
  • Gross total or near-total resection was achieved in all patients (100%) without postoperative complications.
  • All patients remain alive with no evidence of recurrence at a mean follow-up of 33 months.

Conclusions:

  • Neoadjuvant chemotherapy followed by second-look surgery is an effective strategy for maximizing safe resection of pediatric pineal region tumors.
  • This multimodal approach helps overcome the challenges associated with surgical access and tumor characteristics.
  • The combination leads to favorable oncological outcomes and preserves patient quality of life.