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Tumor-related epilepsy in high-grade glioma: a large series survival analysis.
- Source :
-
Journal of neuro-oncology [J Neurooncol] 2024 Oct; Vol. 170 (1), pp. 153-160. Date of Electronic Publication: 2024 Aug 05. - Publication Year :
- 2024
-
Abstract
- Purpose: Seizures are a common clinical occurrence in high-grade glioma (HGG). While many studies have explored seizure incidence and prevalence in HGG, limited studies have examined the prognostic effect of seizures occurring in the post-diagnosis setting. This study aims to assess the impact of seizure presentation on HGG survival outcomes.<br />Methods: Single-center retrospective review identified 950 patients with histologically-confirmed high-grade glioma. Seizure presentation was determined by clinical history and classified as early onset (occurring within 30 days of HGG presentation) or late onset (first seizure occurring after beginning HGG treatment). The primary outcome, hazard ratios for overall survival and progression-free survival, was assessed with multivariable Cox proportional-hazards models. IDH1 mutation status (assessed through immunohistochemistry) was only consistently available beginning in 2015; subgroup analyses were performed in the subset of patients with known IDH1 status.<br />Results: Epileptic activity before (HR = 0.81, 95% CI = 0.68-0.96, P = 0.017) or after (HR = 0.74, 95% CI = 0.60-0.91, P = 0.005) HGG diagnosis associated with improved overall survival. Additionally, late seizure onset significantly associated with lower odds of achieving partial (OR = 0.25, 95% CI = 0.12-0.53, P = < 0.001) or complete (OR = 0.30, 95% CI = 0.18-0.50, P < 0.001) seizure control than patients with early seizure onset.<br />Conclusions: Clinical seizures both at the time of diagnosis and later during the HGG treatment course are associated with improved overall survival. This association potentially persists for both IDH1-wildtype and IDH1-mutant patients, but further study is required.<br /> (© 2024. The Author(s).)
- Subjects :
- Humans
Male
Female
Middle Aged
Retrospective Studies
Adult
Isocitrate Dehydrogenase genetics
Aged
Survival Analysis
Prognosis
Mutation
Survival Rate
Neoplasm Grading
Follow-Up Studies
Glioma mortality
Glioma complications
Glioma pathology
Brain Neoplasms mortality
Brain Neoplasms complications
Epilepsy etiology
Epilepsy mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1573-7373
- Volume :
- 170
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of neuro-oncology
- Publication Type :
- Academic Journal
- Accession number :
- 39102118
- Full Text :
- https://doi.org/10.1007/s11060-024-04787-z