{"title":"Early postoperative seizures in patients with adult-type diffuse gliomas: Incidence, risk factors, and clinical outcomes.","authors":"Jiajia Liu, Gan You, Shengyu Fang, Shimeng Weng, Zhong Zhang, Xing Fan, Hui Qiao","doi":"10.1002/epd2.70019","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The current study aimed to clarify the representation of early postoperative seizures (EPSs) in different glioma subtypes under the 2021 WHO classification, explore the risk factors for EPSs in glioma patients, and investigate the clinical impact of EPSs on seizure and survival outcomes.</p><p><strong>Methods: </strong>Data from 78 patients were analyzed. The differences in clinical-pathological features between patients with EPSs and those without were compared using appropriate statistical methods. Multivariate binary logistic regression analysis was subsequently conducted to explore potential risk factors for EPSs. Finally, the Kaplan-Meier method was applied to analyze the correlation of EPSs with progression-free survival and overall survival.</p><p><strong>Results: </strong>Early postoperative seizures occurred in 17 patients (21.8%). The incidence of EPSs was highest in patients with oligodendroglioma, IDH-mutant, and 1p/19q-codeleted (25.7%), followed by astrocytoma, IDH-mutant (20.8%), and glioblastoma, IDH-wildtype (12.5%). An extent of resection (EOR) of less than 92.24% was identified as the only independent predictor for EPSs (Odds ratio 8.490, 95% confidence interval 1.873-38.488, p = .006) through multivariate regression analysis. In addition, EPSs showed no significant impact on late postoperative seizure occurrence and survival outcome.</p><p><strong>Significance: </strong>In glioma patients, EPSs are considered neurological disorders induced by surgery-related factors rather than a tumor-related mechanism. EPSs are more prone to occur in patients with an EOR of less than 92.24%, which can contribute to improving individualized glioma management.</p>","PeriodicalId":50508,"journal":{"name":"Epileptic Disorders","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Epileptic Disorders","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/epd2.70019","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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Abstract
Objective: The current study aimed to clarify the representation of early postoperative seizures (EPSs) in different glioma subtypes under the 2021 WHO classification, explore the risk factors for EPSs in glioma patients, and investigate the clinical impact of EPSs on seizure and survival outcomes.
Methods: Data from 78 patients were analyzed. The differences in clinical-pathological features between patients with EPSs and those without were compared using appropriate statistical methods. Multivariate binary logistic regression analysis was subsequently conducted to explore potential risk factors for EPSs. Finally, the Kaplan-Meier method was applied to analyze the correlation of EPSs with progression-free survival and overall survival.
Results: Early postoperative seizures occurred in 17 patients (21.8%). The incidence of EPSs was highest in patients with oligodendroglioma, IDH-mutant, and 1p/19q-codeleted (25.7%), followed by astrocytoma, IDH-mutant (20.8%), and glioblastoma, IDH-wildtype (12.5%). An extent of resection (EOR) of less than 92.24% was identified as the only independent predictor for EPSs (Odds ratio 8.490, 95% confidence interval 1.873-38.488, p = .006) through multivariate regression analysis. In addition, EPSs showed no significant impact on late postoperative seizure occurrence and survival outcome.
Significance: In glioma patients, EPSs are considered neurological disorders induced by surgery-related factors rather than a tumor-related mechanism. EPSs are more prone to occur in patients with an EOR of less than 92.24%, which can contribute to improving individualized glioma management.
期刊介绍：
Epileptic Disorders is the leading forum where all experts and medical studentswho wish to improve their understanding of epilepsy and related disorders can share practical experiences surrounding diagnosis and care, natural history, and management of seizures.
Epileptic Disorders is the official E-journal of the International League Against Epilepsy for educational communication. As the journal celebrates its 20th anniversary, it will now be available only as an online version. Its mission is to create educational links between epileptologists and other health professionals in clinical practice and scientists or physicians in research-based institutions. This change is accompanied by an increase in the number of issues per year, from 4 to 6, to ensure regular diffusion of recently published material (high quality Review and Seminar in Epileptology papers; Original Research articles or Case reports of educational value; MultiMedia Teaching Material), to serve the global medical community that cares for those affected by epilepsy.
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