ORIGINAL ARTICLE - PEDIATRIC NEUROSURGERY Outcome and prognostic features in paediatric pineoblastomas: analysis of cases from the Surveillance, Epidemiology, and End Results registry (1990–2007) Senthil K. Selvanathan 1 & Oliver Richards 1 & Saira Alli 1 & Martin Elliott 2 & Atul K. Tyagi 1 & Paul D. Chumas 1 Received: 21 November 2018 /Accepted: 10 April 2019 # Springer-Verlag GmbH Austria, part of Springer Nature 2019 Abstract Background Paediatric pineoblastomas are rare central nervous system tumours. Patient and treatment factors associated with outcome are poorly defined and limited to small retrospective case series and single case reports. Methods Using the Surveillance, Epidemiology, and End Results (SEER) cancer registry, we investigated clinical and patho- logical factors associated with outcome in paediatric pineoblastomas. Paediatric patients (< 16 years old) with pineoblastomas diagnosed between 1990 and 2007 were identified from the SEER database. Kaplan-Meier survival analysis and Cox models were used to examine the effect of variables on overall survival. The variables analysed included patient’ s age at diagnosis, gender, race, tumour spread and size, surgical resection and the use of adjuvant radiotherapy. Results Seventy-eight patients were identified from the database. Twelve patients were excluded as 11 had no surgery and one patient was excluded as the surgical status was unknown. Analysis of the remaining 66 patients revealed a median age at diagnosis of 5.5 years. Three patients underwent biopsy. Seventeen patients underwent full and partial resection, respectively. A further 46 patients underwent surgery the nature of which was not recorded. Thirty-nine patients (59.1%) received adjuvant radiotherapy. Eight patients (12.1%) had both surgery (full or partial resection) and radiotherapy. The median overall survival was 40.5 months. Univariate analysis demonstrated that older age at diagnosis was the only positive predictor of overall survival. Conclusion This study represents the largest analysis of paediatric pineoblastomas to date. The only clinically relevant prognostic factor was older age at diagnosis. The role of surgery and adjuvant radiotherapy on overall survival remains to be defined. Keywords Pineoblastomas . SEER . Epidemiology . Survival . Outcome Abbreviations CCLG Children’ s Cancer and Leuakaemia Group CI Confidence interval CSF Cerebrospinal fluid HR Hazard ratio ICD International classification of diseases MGMT O 6 -methylguanin-DNA-methyltransferase NCI National Cancer Institute OS Overall survival PBL Pineoblastoma SEER Surveillance, Epidemiology, and End Results sPNET Supratentorial primitive neuroectodermal tumour UK United Kingdom US United States WHO World Health Organisation Introduction Pineoblastoma (PBL) is considered to be a World Health Organisation (WHO) Grade IV lesion [1, 2]. It is categorised as a supratentorial primitive neuroectodermal tumour (sPNET) localised to the pineal gland [3]. Histologically, PNET lesions are characterised as being highly cellular and have a high mitotic index. These tumours often disseminate widely within the central nervous system via the cerebrospinal This article is part of the Topical Collection on Pediatric Neurosurgery * Oliver Richards oliver.richards@nhs.net 1 Department of Neurosurgery, Leeds General Infirmary, Leeds LS1 3EX, UK 2 Department of Paediatric Oncology, Leeds General Infirmary, Leeds LS1 3EX, UK Acta Neurochirurgica https://doi.org/10.1007/s00701-019-03909-1