title: Clinicopathological factors predictive of postoperative seizures in patients with gliomas.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.affiliation: 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.
authors.forename: Pei
authors.initials: P
authors.lastname: Yang
authors.affiliation: Beijing Neurosurgical Institute, Capital Medical University, Beijing 100050, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Tingyu
authors.initials: T
authors.lastname: Liang
authors.affiliation: 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.
authors.forename: Chuanbao
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Jinquan
authors.initials: J
authors.lastname: Cai
authors.affiliation: 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.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.
authors.forename: Baoshi
authors.initials: B
authors.lastname: Chen
authors.affiliation: Department of Radiation Therapy, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Xiaoguang
authors.initials: X
authors.lastname: Qiu
authors.affiliation: Department of Pathology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Yao
authors.affiliation: Department of Pathology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
authors.forename: Guilin
authors.initials: G
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Guangdong Zhujiang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Haoyuan
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
authors.forename: Chuanlu
authors.initials: C
authors.lastname: Jiang
authors.affiliation: 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.
authors.forename: Gan
authors.initials: G
authors.lastname: You
authors.affiliation: 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.
authors.forename: Tao
authors.initials: T
authors.lastname: Jiang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000401:mortality / Q000601:surgery*; D015254:DNA Modification Methylases / Q000235:genetics / Q000378:metabolism*; D045643:DNA Repair Enzymes / Q000235:genetics / Q000378:metabolism*; D066246:ErbB Receptors / Q000235:genetics / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D015972:Gene Expression Regulation, Neoplastic / Q000502:physiology; D005910:Glioma / Q000401:mortality / Q000601:surgery*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D051059:PTEN Phosphohydrolase / Q000235:genetics / Q000378:metabolism; D011183:Postoperative Complications / Q000378:metabolism* / Q000401:mortality; D011788:Quality of Life / Q000523:psychology; D012189:Retrospective Studies; D012640:Seizures / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D025521:Tumor Suppressor Proteins / Q000235:genetics / Q000378:metabolism*; D055815:Young Adult
chemical_list: D025521:Tumor Suppressor Proteins; D015254:DNA Modification Methylases; C515491:MGMT protein, human; D066246:ErbB Receptors; D051059:PTEN Phosphohydrolase; C494929:PTEN protein, human; D045643:DNA Repair Enzymes
keywords: EGFR; High-grade gliomas; MGMT; Seizure