Browsing by Author "Bin Alamer, Othman"

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    Metastases in the Pineal Region: A Systematic Review of Clinical Features, Management Strategies, and Survival Outcomes
    (Elsevier, 2022) Palmisciano, Paolo; Ogasawara, Christian; Nwagwu, Chibueze D.; Bin Alamer, Othman; Gupta, Aditya D.; Giantini-Larsen, Alexandra M.; Scalia, Gianluca; Yu, Kenny; Umana, Giuseppe E.; Cohen-Gadol, Aaron A.; El Ahmadieh, Tarek Y.; Haider, Ali S.; Neurological Surgery, School of Medicine
    Background: Pineal region metastases are rare but often cause severe neurologic deficits. Surgical resection and chemoradiotherapy can provide therapeutic benefit. We investigated the literature to analyze clinical characteristics, management strategies, and survival of adult patients with pineal region metastases. Methods: PubMed, Embase, Scopus, and Cochrane were searched following the PRISMA guidelines, including studies reporting clinical outcomes of patients with pineal region metastases. Clinical presentation, management, and survival were reviewed. Results: We included 31 studies comprising 47 patients. Lung cancer (29.8%) and carcinomas of unknown origin (14.9%) were the most frequent primary tumors. In 48.9% of patients, symptomatic pineal metastases preceded primary tumor diagnosis. Headache (67.4%) and confusion (46.5%) were the most common symptoms. Parinaud syndrome (46.5%) and hydrocephalus (87.2%) were noted. Biopsy (65.9%) was preferred over resection (34.1%), and shunting strategies used were endoscopic third ventriculostomy (43.9%) and ventriculoperitoneal (26.8%). Eleven patients (32.3%) received adjuvant chemotherapy and 32 (68%) received radiotherapy. Posttreatment improvement in symptoms (56.6%) and hydrocephalus (80.5%) were noted. In patients who received adjuvant chemotherapy/radiotherapy, significant improvement in posttreatment performance status occurred with both biopsy (P < 0.001) and resection (P = 0.007). No survival differences were reported between surgery and biopsy (P = 0.912) or between complete and partial resection (P = 0.220). Overall survival was neither influenced by surgical approach (P = 0.157) nor by shunting strategy (P = 0.822). Mean follow-up was 8 months and median overall survival 3 months. Only 2 cases (4.8%) of pineal metastasis showed recurrence. Conclusions: Pineal region metastases carry significant morbidity. Biopsy or surgical resection, combined with adjuvant chemotherapy/radiotherapy and/or shunting, may significantly improve performance status.
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    Pineal Region Gliomas: A Systematic Review of Clinical Features and Treatment Outcomes
    (International Institute of Anticancer Research, 2022) Bin Alamer, Othman; Palmisciano, Paolo; Rowe, Scott E.; Gupta, Aditya Dutta; Haider, Maryam; Alduhaymi, Mohammed; Cohen-Gadol, Aaron A.; Yu, Kenny; El-Ahmadieh, Tarek Y.; Haider, Ali S.; Neurological Surgery, School of Medicine
    Background/aim: To review the current literature on pineal region gliomas, summarizing the clinical characteristics and treatment outcomes. Materials and methods: PubMed, Scopus, and Cochrane databases were used to identify relevant articles. Comprehensive clinical characteristic review and survival analysis were conducted. Results: Twelve studies describing 81 patients were included. The median age was 39 years (male=54.3%). Fifty patients (61.7%) had obstructive hydrocephalus requiring cerebrospinal fluid diversion with either ventriculoperitoneal shunt (VPS) (40.0%) or endoscopic third ventriculostomy (ETV) (24.0%). Patients who underwent VPS had significant survival benefits compared to ETV (p<0.05). All patients in our review underwent surgery, and gross-total resection (≥98%) was achieved in 34.6%. The supracerebellar infratentorial approach was the most employed surgical approach (62.3%). Chemotherapy was administered in 32.1% of cases, and radiotherapy in 40.7%. The median overall survival (OS) was 12 months, and the overall one-year survival rate was 60%. Conclusion: This study could not establish a correlation between the extent of tumor resection and positive treatment outcomes. However, among cases with hydrocephalus, patients who underwent VPS placement had better survival as compared to ETV.