title: Epileptic seizures in diffuse low-grade gliomas in adults.
abstract: Diffuse low-grade gliomas are highly epileptogenic brain tumours. We aimed to explore the natural course of epileptic seizures, their predictors and the prognostic significance of their occurrence in adult patients harbouring a diffuse low-grade glioma. An observational retrospective multicentre study examined 1509 patients with diffuse low-grade gliomas to identify mutual interactions between tumour characteristics, tumour course and epileptic seizures. At diagnosis, 89.9% of patients had epileptic seizures. Male gender (P = 0.003) and tumour location within functional areas (P = 0.001) were independent predictors of a history of epileptic seizures at diagnosis. Tumour volume, growth velocity, cortical location, histopathological subtype or molecular markers did not significantly affect epileptic seizure occurrence probability. Prolonged history of epileptic seizures (P < 0.001), insular location (P = 0.003) and tumour location close to functional areas (P = 0.038) were independent predictors of uncontrolled epileptic seizures at diagnosis. Occurrence of epileptic seizures (P < 0.001), parietal (P = 0.029) and insular (P = 0.002) locations were independent predictors of uncontrolled epileptic seizures after oncological treatment. Patient age (P < 0.001), subtotal (P = 0.007) and total (P < 0.001) resections were independent predictors of total epileptic seizure control after oncological treatment. History of epileptic seizures at diagnosis and total surgical resection were independently associated with increased malignant progression-free (P < 0.001 and P < 0.001) and overall (P < 0.001 and P = 0.016) survivals. Epileptic seizures are independently associated with diffuse low-grade glioma prognosis. Patients diagnosed with epileptic seizures and those with complete and early surgical resections have better oncological outcomes. Early and maximal surgical resection is thus required for diffuse low-grade gliomas, both for oncological and epileptological purposes.
authors.affiliation: 1 Department of Neurosurgery, Sainte-Anne Hospital, Paris, France.
authors.forename: Johan
authors.initials: J
authors.lastname: Pallud
authors.forename: Etienne
authors.initials: E
authors.lastname: Audureau
authors.forename: Marie
authors.initials: M
authors.lastname: Blonski
authors.forename: Nader
authors.initials: N
authors.lastname: Sanai
authors.forename: Luc
authors.initials: L
authors.lastname: Bauchet
authors.forename: Denys
authors.initials: D
authors.lastname: Fontaine
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Mandonnet
authors.forename: Edouard
authors.initials: E
authors.lastname: Dezamis
authors.forename: Dimitri
authors.initials: D
authors.lastname: Psimaras
authors.forename: Jacques
authors.initials: J
authors.lastname: Guyotat
authors.forename: Philippe
authors.initials: P
authors.lastname: Peruzzi
authors.forename: Philippe
authors.initials: P
authors.lastname: Page
authors.forename: Beatriz
authors.initials: B
authors.lastname: Gal
authors.forename: Eduardo
authors.initials: E
authors.lastname: Párraga
authors.forename: Marie-Hélène
authors.initials: MH
authors.lastname: Baron
authors.forename: Michaela
authors.initials: M
authors.lastname: Vlaicu
authors.forename: Rémy
authors.initials: R
authors.lastname: Guillevin
authors.forename: Bertrand
authors.initials: B
authors.lastname: Devaux
authors.forename: Hugues
authors.initials: H
authors.lastname: Duffau
authors.forename: Luc
authors.initials: L
authors.lastname: Taillandier
authors.forename: Laurent
authors.initials: L
authors.lastname: Capelle
authors.forename: Gilles
authors.initials: G
authors.lastname: Huberfeld
mesh_terms: D000328:Adult; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D016208:Databases, Factual / Q000639:trends; D018572:Disease-Free Survival; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005910:Glioma / Q000175:diagnosis* / Q000453:epidemiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: diffuse low-grade gliomas; epileptic seizures; predictors; prognosis; surgery