Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular Stratification
Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular Stratification
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DOI：
10.3390/cancers12020397
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发表时间：
2020-02-01
期刊：
影响因子：
5.2
通讯作者：
Skrap, Miran
中科院分区：
文献类型：
--
作者：
Ius, Tamara;Pauletto, Giada;Skrap, Miran
肿瘤切除范围（EOR）作为预后的主要预测因子已被广泛证实，但其对肿瘤相关癫痫的影响研究较少。共入组了155例幕上弥漫性低级别胶质瘤（DLGG）一线手术后的患者。根据2016年WHO分类，通过肿瘤体积数据和分子标志物对结果进行分层，分析术后癫痫发作结局。计算受试者工作特征（ROC）曲线，以评估EOR、残留肿瘤体积和对应于最佳癫痫发作结局的Delta T2 T1 MRI指数（表示肿瘤生长模式）。术后18个月无复发率为70.97%。IDH 1/2突变和1 p/19 q共缺失亚组中观察到更好的癫痫结局。在多变量分析中，年龄（p = 0.014）、EOR（p = 0.030）、Delta T2 T1 MRI指数（p = 0.016）是术后癫痫控制的独立预测因素。改善术后癫痫结局的最佳参数为EOR ≥ 85%，Delta T2 T1 MRI指数
The importance of the extent of resection (EOR) has been widely demonstrated as the main predictor for survival, nevertheless its effect on tumor related epilepsy is less investigated. A total of 155 patients were enrolled after a first-line surgery for supratentorial Diffuse Low Grade Gliomas (DLGGs). Postoperative seizure outcome was analyzed stratifying the results by tumor volumetric data and molecular markers according to 2016 WHO classification. Receiver operating characteristic (ROC) curves were computed to asses EOR, residual tumor volume, and Delta T2T1 MRI index (expressing the tumor growing pattern) corresponding to optimal seizure outcome. A total of 70.97% of patients were seizure-free 18 months after surgery. Better seizure outcome was observed in IDH1/2 mutated and 1p/19q codeleted subgroup. At multivariate analysis, age (p = 0.014), EOR (p = 0.030), Delta T2T1 MRI index (p = 0.016) resulted as independent predictors of postoperative seizure control. Optimal parameters to improve postoperative seizure outcome were EOR >= 85%, Delta T2T1 MRI index