Mirketa Marku1,2,3, Birthe Krogh Rasmussen4, Federica Belmonte5, Steinbjørn Hansen6,7, Elisabeth Anne Wreford Andersen5, Christoffer Johansen8,9, Pernille Envold Bidstrup8,10. 1. Department of Neurology, North Zealand Hospital, University of Copenhagen, Hilleroed, Denmark. mirketa.marku@regionh.dk. 2. Psychological Aspects of Cancer, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark. mirketa.marku@regionh.dk. 3. Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. mirketa.marku@regionh.dk. 4. Department of Neurology, North Zealand Hospital, University of Copenhagen, Hilleroed, Denmark. 5. Statistics and Data Analysis Unit, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark. 6. Department of Oncology, Odense University Hospital, Odense, Denmark. 7. Department of Clinical Research, University of Southern Denmark, Odense, Denmark. 8. Psychological Aspects of Cancer, Danish Cancer Society Research Center, Danish Cancer Society, Copenhagen, Denmark. 9. Cancer Survivorship and Treatment Late Effects (CASTLE), 9601, Department of Oncology, Centre for Cancer and Organ Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. 10. Department of Psychology, University of Copenhagen, Copenhagen, Denmark.
Abstract
OBJECTIVE: Considering that epilepsy is common, and knowledge is lacking on its role especially for the prognosis of high-grade gliomas, the objective of this study was to investigate the association between epilepsy prior to glioma diagnosis and survival among glioma patients. METHODS: In a nationwide population-based cohort study, we included 3763 adult glioma patients diagnosed between 2009 and 2018 according to the Danish Neuro-Oncology Registry. Information on epilepsy was redeemed through Danish Neuro-Oncology Registry, National Patient Registry, and National Prescription Registry. Cox proportional hazard models with 95% confidence intervals (CIs) were applied to examine hazard ratios (HRs) for the association between epilepsy (< 1 year prior to glioma including epilepsy at onset; 1-10 years prior to glioma; no prior epilepsy) and risk of death, and whether it differed according to tumor grade and size, performance status, and treatment modalities. RESULTS: A 32% decreased risk of death in patients with epilepsy within 1 year prior to glioma compared to no prior epilepsy was found (HR = 0.68; CI 0.63-0.75). A favorable prognosis was seen for epilepsy in all glioma grades: II (HR = 0.55; CI 0.39-0.77), III (HR = 0.59; CI 0.48-0.73), and IV (HR = 0.85; CI 0.77-0.94). CONCLUSIONS: Patients with epilepsy within 1 year prior to glioma diagnosis had significant survival benefits compared to patients with no prior epilepsy. This association was significant for both low-grade gliomas (grade II) and high-grade gliomas (grade III and IV). Survival benefits in glioma patients with epilepsy at onset are possibly primarily attributable to tumor-specific histopathology, molecular biomarkers, and early diagnosis.
OBJECTIVE: Considering that epilepsy is common, and knowledge is lacking on its role especially for the prognosis of high-grade gliomas, the objective of this study was to investigate the association between epilepsy prior to glioma diagnosis and survival among glioma patients. METHODS: In a nationwide population-based cohort study, we included 3763 adult glioma patients diagnosed between 2009 and 2018 according to the Danish Neuro-Oncology Registry. Information on epilepsy was redeemed through Danish Neuro-Oncology Registry, National Patient Registry, and National Prescription Registry. Cox proportional hazard models with 95% confidence intervals (CIs) were applied to examine hazard ratios (HRs) for the association between epilepsy (< 1 year prior to glioma including epilepsy at onset; 1-10 years prior to glioma; no prior epilepsy) and risk of death, and whether it differed according to tumor grade and size, performance status, and treatment modalities. RESULTS: A 32% decreased risk of death in patients with epilepsy within 1 year prior to glioma compared to no prior epilepsy was found (HR = 0.68; CI 0.63-0.75). A favorable prognosis was seen for epilepsy in all glioma grades: II (HR = 0.55; CI 0.39-0.77), III (HR = 0.59; CI 0.48-0.73), and IV (HR = 0.85; CI 0.77-0.94). CONCLUSIONS: Patients with epilepsy within 1 year prior to glioma diagnosis had significant survival benefits compared to patients with no prior epilepsy. This association was significant for both low-grade gliomas (grade II) and high-grade gliomas (grade III and IV). Survival benefits in glioma patients with epilepsy at onset are possibly primarily attributable to tumor-specific histopathology, molecular biomarkers, and early diagnosis.
Authors: Jong Woo Lee; Patrick Y Wen; Shelley Hurwitz; Peter Black; Santosh Kesari; Jan Drappatz; Alexandra J Golby; William M Wells; Simon K Warfield; Ron Kikinis; Edward B Bromfield Journal: Arch Neurol Date: 2010-03
Authors: G Bauman; K Lote; D Larson; L Stalpers; C Leighton; B Fisher; W Wara; D MacDonald; L Stitt; J G Cairncross Journal: Int J Radiat Oncol Biol Phys Date: 1999-11-01 Impact factor: 7.038
Authors: Stefan Kölker; Verena Pawlak; Barbara Ahlemeyer; Jürgen G Okun; Friederike Hörster; Ertan Mayatepek; Josef Krieglstein; Georg F Hoffmann; Georg Köhr Journal: Eur J Neurosci Date: 2002-07 Impact factor: 3.386
Authors: Hai Yan; D Williams Parsons; Genglin Jin; Roger McLendon; B Ahmed Rasheed; Weishi Yuan; Ivan Kos; Ines Batinic-Haberle; Siân Jones; Gregory J Riggins; Henry Friedman; Allan Friedman; David Reardon; James Herndon; Kenneth W Kinzler; Victor E Velculescu; Bert Vogelstein; Darell D Bigner Journal: N Engl J Med Date: 2009-02-19 Impact factor: 176.079