title: Early and late epilepsy surgery in focal epilepsies associated with long-term epilepsy-associated tumors.
abstract: OBJECTIVE Epilepsy surgery is an effective means of treating focal epilepsy associated with long-term epilepsy-associated tumors. This study evaluated a large population of surgically treated patients with childhood onset of epilepsy and a histologically confirmed diagnosis of long-term epilepsy-associated tumors. The authors analyzed long-term seizure outcomes to establish whether the time of surgery and patients' ages were determinant factors. METHODS The authors separately investigated several presurgical, surgical, and postsurgical variables in patients operated on before (pediatric group) and at or after (adult group) the age of 18 years. Patients with < 24 months of postsurgical follow-up were excluded from the analysis. RESULTS The patients who underwent surgery before 18 years of age showed better seizure outcomes than those after 18 years of age (80% vs 53.3% Engel Class Ia outcome, respectively; p < 0.001). Multivariate analysis showed that the only variables significantly associated with seizure freedom were complete resection of the lesion, a shorter duration of epilepsy, and temporal lobe resection. CONCLUSIONS The findings of this study indicate that pediatric patients are more responsive to epilepsy surgery and that a shorter duration of epilepsy, complete resection, and a temporal lobe localization are determinant factors for a positive seizure outcome.
authors.affiliation: "Claudio Murani" Epilepsy Surgery Centre, Niguarda Hospital, Milan, Italy; and.
authors.forename: Veronica
authors.initials: V
authors.lastname: Pelliccia
authors.affiliation: Clinical Epileptology and Experimental Neurophysiology Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico, Istituto Neurologico "C. Besta," Milan, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Deleo
authors.affiliation: "Claudio Murani" Epilepsy Surgery Centre, Niguarda Hospital, Milan, Italy; and.
authors.forename: Francesca
authors.initials: F
authors.lastname: Gozzo
authors.affiliation: "Claudio Murani" Epilepsy Surgery Centre, Niguarda Hospital, Milan, Italy; and.
authors.forename: Ivana
authors.initials: I
authors.lastname: Sartori
authors.affiliation: "Claudio Murani" Epilepsy Surgery Centre, Niguarda Hospital, Milan, Italy; and.
authors.forename: Roberto
authors.initials: R
authors.lastname: Mai
authors.affiliation: "Claudio Murani" Epilepsy Surgery Centre, Niguarda Hospital, Milan, Italy; and.
authors.forename: Massimo
authors.initials: M
authors.lastname: Cossu
authors.affiliation: "Claudio Murani" Epilepsy Surgery Centre, Niguarda Hospital, Milan, Italy; and.
authors.forename: Laura
authors.initials: L
authors.lastname: Tassi
mesh_terms: D000293:Adolescent; D000328:Adult; D001932:Brain Neoplasms / Q000150:complications / Q000601:surgery*; D002648:Child; D004828:Epilepsies, Partial / Q000209:etiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: AED = antiepileptic drug; DNT = dysembryoplastic neuroepithelial tumor; EEG = electroencephalography; IQR = interquartile range; LEAT = long-term epilepsy-associated tumor; V-EEG = video EEG; brain MRI; epilepsy surgery; focal symptomatic epilepsy; long-term epilepsy-associated tumors