Pineal gland: Sleep, malignancy and statistics.

Abstract

e14042 Background: The pineal gland is a neuroendocrine gland located deep in the middle brain that regulates the circadian rhythm through Melatonin. Pineal parenchymal tumors arise from pineocytes, have no sexual predominance, occur most frequently in the pediatric population and result in melatonin level disruptions.Pineal region tumors can spread via CSF to other areas in the CNS. The first treatment for pineal region tumors is surgery. Treatments after surgery may include radiation, chemotherapy or clinical trials. Methods: Data was collected from Surveillance, Epidemiology and End Result database Research Plus Data, 17 Registries, Nov 2022 Sub (2000-2020). Pineal gland tumor cases that were labeled as the primary site were extracted from the data base. Further selection was made using the ICD Code D75.3 for neoplasm of pineal gland-primary site labelled. The data was stratified based on age, sex, race and survival curves were compared using the Log-Rank test (GraphPad Prism). Results: A total of 416 pineal gland tumor cases were found, of which ~ 50.48% were males. These tumors were most commonly seen in White (51.68%) patients followed by Hispanic (23.32%), Black (16.10%), Asians/Pacific Islander (6.97%) and Alaskans/Native American (0.96%) patients. The median age of diagnosis was 24.5 years. The incidence rate (per 1,000,000 population) for the general population has increased from 0.69 in 2000 to 0.73 in 2020. As of 2020, the incidence was noted to be higher in males, although overall the incidence among females has been ion the rise. Incidence rate was highest among the Native Americans/Alaskans population followed by Hispanics, Asians/Pacific Islanders, Blacks and Whites. Within the races, incidence was noted to be increasing in the Native Americans/Alaskans & Hispanic populations, stable in the Asians/Pacific Islanders & Black populations and decreasing amongst the White population over the period of 20 years. When the survival curves were compared on the basis of gender and race, the data was clinically significant only for gender. The median of survival (mOS) for males was 146 months but was undefined for females (CI:5.344-12.55, HR: 8.191, p <0.0001) mostly likely due to zero death events being recorded for females. Conclusions: Pineal gland tumors are rarely encountered malignancy with only 416 case reported in the last two decades. It has an almost equal predilection for males and females, more common in the younger population. The incidence is higher among males, although being relatively constant since 2000, and is trending up in females. Overall survival was superior in females with no reported death events. Native Americans/Alaskans are more affected overall survival is independent of the race.