Factors contributing to resectability and seizure outcomes in 44 patients with ganglioglioma.

OBJECTIVES: The purpose of this retrospective study was to evaluate causes contributing to surgical resectability and seizure outcomes depending on various clinical and surgical factors. PATIENTS AND METHODS: The records of 44 patients with gangliogliomas surgically treated between April 1986 and March 2007, were retrospectively reviewed to assess presenting symptoms, resectability and seizure outcomes.
RESULTS: Tumors were located in the supratentorial areas in 33 cases, the infratentorial area in 9 cases and the spinal cord in 2 cases. Thirty-five cases underwent gross total removal and 9 cases underwent subtotal resection. Only 2 cases underwent postoperative radiotherapy and 2 cases underwent gamma knife surgery. Twenty-six patients presented seizure symptoms of which 22 cases were located in temporal lobe and 4 cases were located in the extratemporal lobe. Twenty-three patients (88.5%) were seizure-free after surgery. Two patients were Engel class II and another was Engel class III.
CONCLUSION: We concluded that tumor location and seizure-presenting symptoms are good predictors of gross total removal. Gross total removal of ganglioglioma had a better chance of leaving the patient seizure free after surgery rather incomplete resection. Our data do not support the concept that surgical methods, invasive monitoring and surrounding cortical malformation correlated with seizure-free outcome.