Clinical Characteristics Associated with Postoperative Seizure Control in Adult Low-grade Gliomas: a Systematic Review and Meta-analysis

Overview

Journal Neuro Oncol

Publisher Oxford University Press

Specialties Neurology
Oncology

Date 2017 Oct 11

PMID 29016869

Citations 24

Authors

Xia Shan

Xing Fan

Xing Liu

Zheng Zhao

Yinyan Wang

Tao Jiang

Affiliations

Soon will be listed here.

Abstract

Background: Epilepsy is the most common symptom in patients with supratentorial low-grade gliomas (LGGs), which adversely affects the patient's quality of life. Poor seizure control with anti-epileptic therapy is an indication for surgery in these patients. Recent studies have sought to identify predictors of postoperative seizure control after surgical resection of LGG; gross total resection was shown to be a significant predictor in this respect. However, the prognostic value of other factors is not clear.

Methods: We performed a systematic review and meta-analysis of 23 studies with a combined study population of 2641 patients with LGG, in order to identify potential factors associated with favorable postoperative seizure control. Data were extracted on age and sex of patient, tumor location, tumor histology, type of seizure, seizure duration, extent of resection, and imaging characteristics.

Results: Patients ≥45 years of age achieved better postoperative seizure control (risk ratio [RR], 0.89; 95% CI, 0.81-0.99). Focal seizures were associated with poor seizure control (RR, 1.32; 95% CI, 1.18-1.49) compared with generalized seizures (RR, 0.77; 95% CI, 0.68-0.87). Prolonged history of seizures (≥1 y) had a negative impact on postoperative seizure control (RR, 1.22; 95% CI, 1.10-1.34). Gross total resection was superior to subtotal resection with respect to postoperative seizure control (RR, 0.68; 95% CI, 0.63-0.73).

Conclusions: This systematic review and meta-analysis identified predictors of postoperative seizure control in patients undergoing surgical resection of LGGs. Our results provide a reference for clinical treatment of LGG-related epilepsy.

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References

You G, Feng L, Yan W, Zhang W, Wang Y, Li S . BCL2A1 is a potential biomarker for postoperative seizure control in patients with low-grade gliomas. CNS Neurosci Ther. 2013; 19(11):882-8. PMC: 6493500. DOI: 10.1111/cns.12148. View

Chang E, Potts M, Keles G, Lamborn K, Chang S, Barbaro N . Seizure characteristics and control following resection in 332 patients with low-grade gliomas. J Neurosurg. 2008; 108(2):227-35. DOI: 10.3171/JNS/2008/108/2/0227. View

de Oliveira Lima G, Duffau H . Is there a risk of seizures in "preventive" awake surgery for incidental diffuse low-grade gliomas?. J Neurosurg. 2015; 122(6):1397-405. DOI: 10.3171/2014.9.JNS141396. View

Louis D, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee W . The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016; 131(6):803-20. DOI: 10.1007/s00401-016-1545-1. View

Lote K, Stenwig A, Skullerud K, Hirschberg H . Prevalence and prognostic significance of epilepsy in patients with gliomas. Eur J Cancer. 1998; 34(1):98-102. DOI: 10.1016/s0959-8049(97)00374-2. View

Guyatt G, Oxman A, Vist G, Kunz R, Falck-Ytter Y, Alonso-Coello P . GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008; 336(7650):924-6. PMC: 2335261. DOI: 10.1136/bmj.39489.470347.AD. View

You G, Sha Z, Yan W, Zhang W, Wang Y, Li S . Seizure characteristics and outcomes in 508 Chinese adult patients undergoing primary resection of low-grade gliomas: a clinicopathological study. Neuro Oncol. 2011; 14(2):230-41. PMC: 3266386. DOI: 10.1093/neuonc/nor205. View

Luyken C, Blumcke I, Fimmers R, Urbach H, Elger C, Wiestler O . The spectrum of long-term epilepsy-associated tumors: long-term seizure and tumor outcome and neurosurgical aspects. Epilepsia. 2003; 44(6):822-30. DOI: 10.1046/j.1528-1157.2003.56102.x. View

Stewart L, Clarke M, Rovers M, Riley R, Simmonds M, Stewart G . Preferred Reporting Items for Systematic Review and Meta-Analyses of individual participant data: the PRISMA-IPD Statement. JAMA. 2015; 313(16):1657-65. DOI: 10.1001/jama.2015.3656. View

10.

Bauer R, Dobesberger J, Unterhofer C, Unterberger I, Walser G, Bauer G . Outcome of adult patients with temporal lobe tumours and medically refractory focal epilepsy. Acta Neurochir (Wien). 2007; 149(12):1211-6. DOI: 10.1007/s00701-007-1366-z. View

11.

Ius T, Pauletto G, Isola M, Gregoraci G, Budai R, Lettieri C . Surgery for insular low-grade glioma: predictors of postoperative seizure outcome. J Neurosurg. 2013; 120(1):12-23. DOI: 10.3171/2013.9.JNS13728. View

12.

Englot D, Han S, Berger M, Barbaro N, Chang E . Extent of surgical resection predicts seizure freedom in low-grade temporal lobe brain tumors. Neurosurgery. 2011; 70(4):921-8. DOI: 10.1227/NEU.0b013e31823c3a30. View

13.

Berger M, Ghatan S, Haglund M, Dobbins J, Ojemann G . Low-grade gliomas associated with intractable epilepsy: seizure outcome utilizing electrocorticography during tumor resection. J Neurosurg. 1993; 79(1):62-9. DOI: 10.3171/jns.1993.79.1.0062. View

14.

Bartolomei J, Christopher S, Vives K, Spencer D, Piepmeier J . Low-grade gliomas of chronic epilepsy: a distinct clinical and pathological entity. J Neurooncol. 1997; 34(1):79-84. DOI: 10.1023/a:1005711321343. View

15.

Schucht P, Ghareeb F, Duffau H . Surgery for low-grade glioma infiltrating the central cerebral region: location as a predictive factor for neurological deficit, epileptological outcome, and quality of life. J Neurosurg. 2013; 119(2):318-23. DOI: 10.3171/2013.5.JNS122235. View

16.

Schaller B, Ruegg S . Brain tumor and seizures: pathophysiology and its implications for treatment revisited. Epilepsia. 2003; 44(9):1223-32. DOI: 10.1046/j.1528-1157.2003.05203.x. View

17.

Duffau H, Capelle L, Lopes M, Bitar A, Sichez J, Van Effenterre R . Medically intractable epilepsy from insular low-grade gliomas: improvement after an extended lesionectomy. Acta Neurochir (Wien). 2002; 144(6):563-72; discussion 572-3. DOI: 10.1007/s00701-002-0941-6. View

18.

Jiang J, Tang Q, Feng J, Dai R, Wang Y, Yang Y . Association between SLCO1B1 -521T>C and -388A>G polymorphisms and risk of statin-induced adverse drug reactions: A meta-analysis. Springerplus. 2016; 5(1):1368. PMC: 4991977. DOI: 10.1186/s40064-016-2912-z. View

19.

Tanriverdi T, Kemerdere R, Baran O, Sayyahmelli S, Ozlen F, Isler C . Long-term surgical and seizure outcomes of frontal low-grade gliomas. Int J Surg. 2016; 33 Pt A:60-4. DOI: 10.1016/j.ijsu.2016.07.065. View

20.

Smith J, Chang E, Lamborn K, Chang S, Prados M, Cha S . Role of extent of resection in the long-term outcome of low-grade hemispheric gliomas. J Clin Oncol. 2008; 26(8):1338-45. DOI: 10.1200/JCO.2007.13.9337. View