Abstract | PURPOSE: Most patients with Lower Grade Gliomas (LGG) present with epileptic seizures. Since the advent of molecular diagnostics, more homogenous sub-entities have emerged, including the isocitrate dehydrogenase-mutated (IDH-mutated) astrocytomas and 1p19q-codeleted oligodendrogliomas. We aimed to describe the occurrence of seizures in patients with molecularly defined LGG pre- and postoperatively and to analyze factors affecting seizure status postoperatively. METHODS: A population-based cohort of 130 adult patients with IDH-mutated WHO grade 2 or 3 astrocytomas and oligodendrogliomas was assessed pertaining to seizure burden before and after surgery. RESULTS: Fifty-four (79.4%) patients with astrocytoma and 45 (72.6%) patients with oligodendroglioma had a history of seizures before surgery. At 12 months postoperatively, 51/67 (76.1%) patients with astrocytoma and 47/62 (75.8%) patients with oligodendrogliomas were seizure free. In a multivariable logistic regression analysis, lower extent of resection (EOR) (OR 0.98; 95% CI 0.97-1.00, p = 0.01) and insular tumor location (OR 5.02; 95% CI 1.01-24.87, p = 0.048) were associated with presence of seizures within 1 year postoperatively in the entire LGG cohort. In sub-entities, EOR was in a similar manner associated with seizures postoperatively in astrocytomas (OR 0.98; 95% CI 0.96-0.99, p < 0.01) but not in oligodendrogliomas (p = 0.34). CONCLUSION: Our results are well in line with data published for non-molecularly defined LGG with a large proportion of patients being seizure free at 1 year postoperative. Better seizure outcome was observed with increased EOR in astrocytomas, but this association was absent in oligodendrogliomas.
|
Authors | Louise Carstam, Isabelle Rydén, Asgeir Store Jakola |
Journal | Journal of neuro-oncology
(J Neurooncol)
Vol. 160
Issue 2
Pg. 403-411
(Nov 2022)
ISSN: 1573-7373 [Electronic] United States |
PMID | 36258151
(Publication Type: Journal Article)
|
Copyright | © 2022. The Author(s). |
Chemical References |
|
Topics |
- Adult
- Humans
- Isocitrate Dehydrogenase
(genetics)
- Oligodendroglioma
(complications, genetics, surgery)
- Brain Neoplasms
(complications, genetics, surgery)
- Glioma
(complications, genetics, surgery)
- Astrocytoma
(complications, genetics, surgery)
- Seizures
(genetics)
- Mutation
|