Pei Yang1, Tingyu Liang2, Chuanbao Zhang1, Jinquan Cai3, Wei Zhang1, Baoshi Chen4, Xiaoguang Qiu5, Kun Yao6, Guilin Li7, Haoyuan Wang8, Chuanlu Jiang3, Gan You9, Tao Jiang10. 1. Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; Chinese Glioma Cooperative Group (CGCG), China. 2. Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China. 3. Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. 4. Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China. 5. Department of Radiation Therapy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 6. Department of Pathology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China. 7. Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China. 8. Department of Neurosurgery, Guangdong Zhujiang Hospital, Southern Medical University, Guangzhou, China. 9. Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; Chinese Glioma Cooperative Group (CGCG), China. Electronic address: yougan1105@sohu.com. 10. Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China; Chinese Glioma Cooperative Group (CGCG), China. Electronic address: taojiang1964@163.com.
Abstract
PURPOSE: Epilepsy is one of the most common manifestations in gliomas and has a severe effect on the life expectancy and quality of life of patients. The aim of our study was to assess the potential connections between clinicopathological factors and postoperative seizure. METHOD: We retrospectively investigated a group of 147 Chinese high-grade glioma (HGG) patients with preoperative seizure to examine the correlation between postoperative seizure and clinicopathological factors and prognosis. Univariate analyses and multivariate logistic regression analyses were performed to identify factors associated with postoperative seizures. Survival function curves were calculated using the Kaplan-Meier method. RESULTS: 53 patients (36%) were completely seizure-free (Engel class I), and 94 (64%) experienced a postoperative seizure (Engel classes II, III, and IV). A Chi-squared analysis showed that anaplastic oligodendroglioma/anaplastic oligoastrocytoma (AO/AOA) (P=0.05), epidermal growth factor receptor (EGFR) expression (P=0.0004), O(6)-methylguanine DNA methyltransferase (MGMT) expression (P=0.011), and phosphatase and tensin homolog (PTEN) expression (P=0.045) were all significantly different. A logistic regression analysis showed that MGMT expression (P=0.05), EGFR expression (P=0.001), and AO/AOA (P=0.038) are independent factors of postoperative seizure. Patients with lower MGMT and EGFR expression and AO/AOA showed more frequent instances of postoperative seizure. Postoperative seizure showed no statistical significance on overall survival (OS) and progression-free survival (PFS). CONCLUSION: Our study identified clinicopathological factors related to postoperative seizure in HGGs and found two predictive biomarkers of postoperative seizure: MGMT and EGFR. These findings provided insight treatment strategies aimed at prolonging survival and improving quality of life.
PURPOSE:Epilepsy is one of the most common manifestations in gliomas and has a severe effect on the life expectancy and quality of life of patients. The aim of our study was to assess the potential connections between clinicopathological factors and postoperative seizure. METHOD: We retrospectively investigated a group of 147 Chinese high-grade glioma (HGG) patients with preoperative seizure to examine the correlation between postoperative seizure and clinicopathological factors and prognosis. Univariate analyses and multivariate logistic regression analyses were performed to identify factors associated with postoperative seizures. Survival function curves were calculated using the Kaplan-Meier method. RESULTS: 53 patients (36%) were completely seizure-free (Engel class I), and 94 (64%) experienced a postoperative seizure (Engel classes II, III, and IV). A Chi-squared analysis showed that anaplastic oligodendroglioma/anaplastic oligoastrocytoma (AO/AOA) (P=0.05), epidermal growth factor receptor (EGFR) expression (P=0.0004), O(6)-methylguanine DNA methyltransferase (MGMT) expression (P=0.011), and phosphatase and tensin homolog (PTEN) expression (P=0.045) were all significantly different. A logistic regression analysis showed that MGMT expression (P=0.05), EGFR expression (P=0.001), and AO/AOA (P=0.038) are independent factors of postoperative seizure. Patients with lower MGMT and EGFR expression and AO/AOA showed more frequent instances of postoperative seizure. Postoperative seizure showed no statistical significance on overall survival (OS) and progression-free survival (PFS). CONCLUSION: Our study identified clinicopathological factors related to postoperative seizure in HGGs and found two predictive biomarkers of postoperative seizure: MGMT and EGFR. These findings provided insight treatment strategies aimed at prolonging survival and improving quality of life.
Authors: Kristin M Knudsen-Baas; Anders Engeland; Nils Erik Gilhus; Anette M Storstein; Jone F Owe Journal: J Neurooncol Date: 2016-07-04 Impact factor: 4.130
Authors: Philip C De Witt Hamer; Philip C De Witt Hamer; Martin Klein; Shawn L Hervey-Jumper; Jeffrey S Wefel; Mitchel S Berger Journal: Neurosurgery Date: 2021-03-15 Impact factor: 4.654