title: Prognostic relevance of epilepsy at presentation in glioblastoma patients.
abstract: Epileptogenic glioblastomas are thought to convey a favorable prognosis, either due to early diagnosis or potential antitumor effects of antiepileptic drugs. We investigated the relationship between survival and epilepsy at presentation, early diagnosis, and antiepileptic drug therapy in glioblastoma patients.
  
  
  
  Multivariable Cox regression was applied to survival data of 647 consecutive patients diagnosed with de novo glioblastoma between 2005 and 2013 in order to investigate the association between epilepsy and survival in glioblastoma patients. In addition, we quantified the association between survival and valproic acid (VPA) treatment.
  
  
  
  Epilepsy correlated positively with survival (HR: 0.75 (95% CI: 0.61-0.92), P < .01). This effect is independent of age, sex, performance status, type of surgery, adjuvant therapy, tumor location, and tumor volume, suggesting that this positive correlation cannot be attributed solely to early diagnosis. For patients who presented with epilepsy, the use of the antiepileptic drug VPA did not associate with survival when compared with patients who did not receive VPA treatment.
  
  
  
  Epilepsy is an independent prognostic factor for longer survival in glioblastoma patients. This prognostic effect is not solely explained by early diagnosis, and survival is not associated with VPA treatment.
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Sharon
authors.initials: S
authors.lastname: Berendsen
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Meri
authors.initials: M
authors.lastname: Varkila
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Jérôme
authors.initials: J
authors.lastname: Kroonen
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Tatjana
authors.initials: T
authors.lastname: Seute
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Tom J
authors.initials: TJ
authors.lastname: Snijders
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Frans
authors.initials: F
authors.lastname: Kauw
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Wim G M
authors.initials: WG
authors.lastname: Spliet
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Marie
authors.initials: M
authors.lastname: Willems
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Christophe
authors.initials: C
authors.lastname: Poulet
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Marike L
authors.initials: ML
authors.lastname: Broekman
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Vincent
authors.initials: V
authors.lastname: Bours
authors.affiliation: Brain Center Rudolf Magnus, Department of Neurology and Neurosurgery, University Medical Center, Utrecht, Netherlands (S.B., M.V., J.K., T.S., T.J.S., F.K., M.L.B., P.A.R.); Department of Pathology, University Medical Center Utrecht, Utrecht, Netherlands (W.G.M.S.); Department of Human Genetics, GIGA Research Center, University of Liège, Liège, Belgium (M.W., C.P., V.B., P.A.R.).
authors.forename: Pierre A
authors.initials: PA
authors.lastname: Robe
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000150:complications* / Q000401:mortality*; D004827:Epilepsy / Q000188:drug therapy / Q000209:etiology*; D005260:Female; D005909:Glioblastoma / Q000150:complications* / Q000401:mortality*; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016016:Proportional Hazards Models; D046888:Tissue Array Analysis; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid
keywords: epilepsy; glioblastoma; prognosis; survival; valproic acid