Long-Term Epilepsy-Associated Tumors (LEATs): A Single-Center, Retrospective Series and Review of Literature on Factors Affecting the Seizure Outcome

Mehrotra, Anant; Singh, Shanker K.; Kanjilal, Soumen; Kumar, Ashutosh; Pal, Lily; Mathur, Vrinda; Paliwal, Vimal Kumar; Sardhara, Jayesh; Bhaisora, Kamlesh Singh; Srivastava, Arun Kumar; Jaiswal, Awadhesh Kumar; Behari, Sanjay

doi:10.1016/j.wneu.2020.08.036

Cited by 10 publications

(6 citation statements)

References 31 publications

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“…With respect to electrophysiological factors, few studies have made an adequate or comprehensive analysis of their correlations with seizure outcomes due to the discordant or incomplete electrophysiological data (especially ictal VEEG and MEG findings) in their series. 10,[12][13][14] Two previous studies have reported that patients with VEEG findings of local or unilateral epileptiform discharges had better seizure outcomes than those with bilateral or diffuse discharges, 3,32 which is in line with our results that patients who had lateral (or unilateral) concordant VEEG findings of either interictal or ictal discharge sources with tumor locations were more likely to have favorable seizure outcomes than those with discordant (or bilateral) discharges, but not in the multivariate model. In particular, we found that preoperative MEG findings had a better prediction for postoperative seizure outcomes than…”

Section: Prognostic Factors Of Seizure Outcomessupporting

confidence: 90%

“…In particular, the tumor marker BRAF V600E was detected by immunohistochemistry in 103 (35.9%) patients, of which 59 (57.3%) cases were BRAF V600E (+), including GG (51/84), DNT (5/13), and mixed GNT (3/6). In addition, 219 (76.3%) cases were tested with IDH mutations, but no IDH (+) was found in all tested lesions of GG (174), DNT (32), and other LGENTs (13).…”

Section: Lesion Characteristicsmentioning

confidence: 99%

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The long‐term surgical outcomes of low‐grade epilepsy‐associated neuroepithelial tumors

et al. 2022

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Objective: This study aimed to evaluate the surgical outcomes and relevant prognostic factors in patients with low-grade epilepsy-associated neuroepithelial tumors (LEAT) and, especially, to develop a scoring system to predict postoperative seizure outcomes. Methods:The clinical data of patients who underwent epilepsy surgery for LEAT were retrospectively studied. The surgical outcomes of seizure and neurological statuses in patients were evaluated using Engel classification and modified Rankin Scale (mRS) scoring, respectively. A scoring system of seizure outcomes was constructed based on the weight of the β-coefficient estimate of each predictor in the final multivariate predicting model of seizure outcomes. Results:Of the 287 patients (106 female) enrolled, the median age was 19 years at surgery and 10 years at seizure onset, with a median duration of epilepsy of 60 months. Among 258 patients who were followed up for at least 12 months, 215 (83.3%) patients had a favorable seizure outcome (Engel class I) after surgery, and 43 (16.7%) patients had an unfavorable seizure outcome; longer duration of epilepsy, discordant magnetoencephalography (MEG) findings, and acute postoperative seizures were significantly included in the scoring system to predict unfavorable seizure outcomes, and in the scoring system, accumulated scoring of 0-19 scores was recorded, which were finally grouped into three risk levels: low risk (risk < 30%), medium risk (30% ≤ risk < 70%), and high risk (risk ≥ 70%). In addition, favorable neurological outcomes (mRS score 0-1) were recorded in 187 (72.5%) patients, while unfavorable neurological outcomes were recorded in 71 (27.5%) patients, which were significantly related to poor seizure control, older age at surgery, and longer duration of epilepsy and hospitalization time. Significance:The long-term surgical outcomes of LEAT after surgery were satisfactory. A scoring system for predicting unfavorable seizure outcomes with different risk levels was developed, which could partly guide clinical treatments of LEAT.

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Section: Prognostic Factors Of Seizure Outcomessupporting

confidence: 90%

Section: Lesion Characteristicsmentioning

confidence: 99%

The long‐term surgical outcomes of low‐grade epilepsy‐associated neuroepithelial tumors

et al. 2022

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“…Studies focusing on patients with GG have identified some factors associated with favorable seizure outcomes, such as age at surgery, duration of epilepsy, completeness of tumor, etc. ( 8 , 10 , 13 , 26 – 28 ). In this clinical cohort study, the duration of seizures > two years was a potential factor associated with unfavorable seizure outcomes.…”

Section: Discussionmentioning

confidence: 99%

Seizure outcomes and prognostic factors in patients with gangliogliomas associated with epilepsy

Zhang

Adilijiang

et al. 2022

Front. Surg.

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IntroductionGanglioglioma (GG) patients often present with seizures. Although most patients can be seizure-free after tumor resection, some still experience seizures. The present study aimed to analyze a group of GGs patients associated with epilepsy and evaluate the seizure outcomes and prognostic factors.MethodsThis retrospective study involved clinical data collected from medical records of patients diagnosed with GG pathologically and underwent surgical resection in Sanbo Brain Hospital, Capital Medical University. The seizure outcomes were evaluated based on the International League Against Epilepsy (ILAE) seizure outcome classification. The prognostic factors were identified according to univariate and multivariate analysis.ResultsA total of 222 patients were included, with a mean age at surgery of 19.19 ± 10.93 years. All patients were followed up at least for one year with a mean follow-up duration of 6.28 ± 3.17 years. At the final follow-up, 174 (78.4%) patients achieved ILAE Class 1 or 2. Univariate and multivariate analyses revealed that the short duration of seizures and gross total resection were significant positive factors for seizure-free. Bilateral interictal or ictal epileptiform discharges in preoperative video-electroencephalogram (VEEG) were related to poor seizure outcomes.ConclusionSurgical resection is an effective treatment for patients with epilepsy associated with GGs. The analysis of predictive factors could effectively guide clinical practice and evaluate the prognosis of epilepsy with GG.

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“…Over 50% of patients present with headache (20), hydrocephalus (21,25) and focal neurological deficits. Glioneuronal tumors are by far the most common histological type of brain tumors requiring surgery for epilepsy management (26) and are therefore part of the "low grade epilepsy associated neuroepithelial tumors" family (26)(27)(28)(29). Patients can present with seizures in infancy, childhood or early adulthood and most patients will have a mean duration of epilepsy of approximately 5 years with a range of 0.1 to 35 years (8).…”

Section: Clinical Presentationmentioning

confidence: 99%

Glioneuronal Tumors: Insights into a Rare Tumor Entity

Krauze

2021

Gliomas

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Glioneuronal tumors are a group of rare neoplasms made up of neural and glial components in heterogenous proportions, generally exhibiting WHO grade I clinical behavior. These tumors affect infants, children and young adults, but are also described in adults and the elderly. They are strongly associated with seizures. Tumor subtypes described under the umbrella of glioneuronal tumors are actively evolving but to date comprise central, extraventricular and lipo-neurocytoma, desmoplastic infantile astrocytoma and ganglioglioma, diffuse leptomeningeal glioneuronal tumor, dysembryoplastic neuroepithelial tumor, papillary glioneuronal tumor, rosette-forming glioneuronal tumor of the fourth ventricle, rosetted glioneuronal tumor with neuropil-like islands, gangliocytoma, ganglioglioma, anaplastic ganglioglioma and paraganglioma. They vary in radiographic appearance, with some exhibiting large heterogenous solid/cystic masses. With large scale genetic and molecular analyses ongoing, classification continues to evolve. Seizure management and surgical resection represent the cornerstones of management, with the use of systemic agents and radiation lacking conclusive results. Optimal management requires multidisciplinary discussion including

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Long-Term Epilepsy-Associated Tumors (LEATs): A Single-Center, Retrospective Series and Review of Literature on Factors Affecting the Seizure Outcome

Cited by 10 publications

References 31 publications

The long‐term surgical outcomes of low‐grade epilepsy‐associated neuroepithelial tumors

The long‐term surgical outcomes of low‐grade epilepsy‐associated neuroepithelial tumors

Seizure outcomes and prognostic factors in patients with gangliogliomas associated with epilepsy

Glioneuronal Tumors: Insights into a Rare Tumor Entity

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