Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular Stratification
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 (DLGG...
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doaj-b7bb20fc708e4d7f9178e46cd11d0a962020-11-25T02:33:37ZengMDPI AGCancers2072-66942020-02-0112239710.3390/cancers12020397cancers12020397Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular StratificationTamara Ius0Giada Pauletto1Barbara Tomasino2Marta Maieron3Riccardo Budai4Miriam Isola5Daniela Cesselli6Christian Lettieri7Miran Skrap8Neurosurgery Unit, Department of Neuroscience, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyNeurology Unit, Department of Neuroscience, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyScientific Institute, IRCCS E. Medea, San Vito al Tagliamento, 33078 Pordenone, ItalyMedical Physics, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyNeurology Unit, Department of Neuroscience, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyDepartment of Medicine, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyInstitute of Pathology, Santa Maria della Misericordia University Hospital, 33100 Udine Post, ItalyNeurology Unit, Department of Neuroscience, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyNeurosurgery Unit, Department of Neuroscience, Santa Maria della Misericordia University Hospital, 33100 Udine, ItalyThe 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 ΔT2T1 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 (<i>p</i> = 0.014), EOR (<i>p</i> = 0.030), ΔT2T1 MRI index (<i>p</i> = 0.016) resulted as independent predictors of postoperative seizure control. Optimal parameters to improve postoperative seizure outcome were EOR ≥ 85%, ΔT2T1 MRI index ≤ 18 cm<sup>3</sup>, residual tumor volume ≤ 15 cm<sup>3</sup>. This study confirms the role of EOR and tumor growing pattern on postoperative seizure outcome independently from the molecular class. Higher ΔT2T1 MRI index, representing the infiltrative component of the tumor, is associated with worse seizure outcome and strengthens the evidence of common pathogenic mechanisms underlying tumor growth and postoperative seizure outcome.https://www.mdpi.com/2072-6694/12/2/397low grade gliomaseizure outcomemolecular markersextent of resectiontumor growth patternroc curves |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Tamara Ius Giada Pauletto Barbara Tomasino Marta Maieron Riccardo Budai Miriam Isola Daniela Cesselli Christian Lettieri Miran Skrap |
spellingShingle |
Tamara Ius Giada Pauletto Barbara Tomasino Marta Maieron Riccardo Budai Miriam Isola Daniela Cesselli Christian Lettieri Miran Skrap Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular Stratification Cancers low grade glioma seizure outcome molecular markers extent of resection tumor growth pattern roc curves |
author_facet |
Tamara Ius Giada Pauletto Barbara Tomasino Marta Maieron Riccardo Budai Miriam Isola Daniela Cesselli Christian Lettieri Miran Skrap |
author_sort |
Tamara Ius |
title |
Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular Stratification |
title_short |
Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular Stratification |
title_full |
Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular Stratification |
title_fullStr |
Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular Stratification |
title_full_unstemmed |
Predictors of Postoperative Seizure Outcome in Low Grade Glioma: From Volumetric Analysis to Molecular Stratification |
title_sort |
predictors of postoperative seizure outcome in low grade glioma: from volumetric analysis to molecular stratification |
publisher |
MDPI AG |
series |
Cancers |
issn |
2072-6694 |
publishDate |
2020-02-01 |
description |
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 ΔT2T1 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 (<i>p</i> = 0.014), EOR (<i>p</i> = 0.030), ΔT2T1 MRI index (<i>p</i> = 0.016) resulted as independent predictors of postoperative seizure control. Optimal parameters to improve postoperative seizure outcome were EOR ≥ 85%, ΔT2T1 MRI index ≤ 18 cm<sup>3</sup>, residual tumor volume ≤ 15 cm<sup>3</sup>. This study confirms the role of EOR and tumor growing pattern on postoperative seizure outcome independently from the molecular class. Higher ΔT2T1 MRI index, representing the infiltrative component of the tumor, is associated with worse seizure outcome and strengthens the evidence of common pathogenic mechanisms underlying tumor growth and postoperative seizure outcome. |
topic |
low grade glioma seizure outcome molecular markers extent of resection tumor growth pattern roc curves |
url |
https://www.mdpi.com/2072-6694/12/2/397 |
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