Glioblastoma Multiforme In The Pineal Region: Systematic Review Of The Survival Outcomes

Abstract Purpose: Glioblastoma multiforme of the pineal region harbors high mortality in the first year of treatment. This study aims to deepen the study of pineal GBM patients for finding independent predictors of mortality, focusing on the therapeutic modalities and genetic features.Methods: We present a systematic review of the long-term outcomes of the disease with a focus on the therapeutic modalities and genetic features.Results: The median overall survival of the disease is 12 months. Biopsy (HR:4.2, p=0.002, and a median survival of 19 months) and radiochemotherapy (HR:4.1, p<0.001, and a median survival of 18 months) represent independent predictors of pineal glioblastoma survival. H3K27M mutant patients had a median survival of 23 months versus the ten-months median survival of the H3K27 wild type. However, no statistical difference exists due to the limited number of cases. The disease's local progression and recurrence seem higher in patients undergoing surgical removal than biopsy procedures (p=0.021).Conclusions: Biopsy and radiochemotherapy represent independent predictors of pineal GBM survival. Surgical resection different from biopsy seems to increase the risks of local progression and recurrence. However, further studies should focus on the impact of the genetic profile on long-term outcomes.