Outcomes of Surgery in Patients with Epilepsy who have Low-Grade Tumors

Patients with epilepsy who have low-grade tumors (LGTs) may have successful short- and median-term surgical outcomes, according to a retrospective study that was published in Annals of Clinical and Translational Neurosurgery.

“Long-term postoperative seizure freedom rates in LGT patients vary from 64.6% to 86.7% in most developed countries. The positive predictors for seizure freedom in LGT patients remain hotly debated; some studies suggested that shorter durations and younger ages at surgery yielded good seizure outcomes, whereas others failed to find such correlations,” the study authors stated.

They evaluated patients with LGTs who underwent epilepsy surgery at their center between 2012 and 2018 and who had at least one year of follow-up. Engel’s classification and Kaplan-Meier survival analysis were used to analyze postoperative seizure freedom.

Final analysis comprised 132 patients (79 males, 53 females); through their final follow-up, 110 patients (83.33%) were seizure-free. The following Engel class I outcomes were recorded at the end of the corresponding postoperative year: year 1, 90.15%; year 2, 87.76%; year 3, 85.53%; year 4, 82.46%; and year 5, 73.17%. Upon multivariate logistic analysis, independent factors associated with seizure recurrence through final follow-up were longer epilepsy duration (odds ratio [OR, 1.091; 95% confidence interval [CI], 1.040-1.144; P<0.001) and incomplete resection (OR, 3.673; 95% CI, 1.393-9.684; P=0.009).

“The surgical treatment of LGT provides epilepsy patients in developing countries with a high chance of seizure amelioration. Early surgical intervention and complete tumor resection were independently associated with seizure-free outcomes through the patients’ last follow-up,” the researchers summarized.