New-Onset Postoperative Seizures in Patients With Diffuse Gliomas: A Risk Assessment Analysis

• Published in: Frontiers in neurology 2021-06, Vol.12, p.682535-682535
• Main Authors: Li, Lianwang, Li, Guanzhang, Fang, Shengyu, Zhang, Kenan, Huang, Ruoyu, Wang, Yinyan, Zhang, Chuanbao, Li, Yiming, Zhang, Wei, Zhang, Zhong, Jin, Qiang, Zhou, Dabiao, Fan, Xing, Jiang, Tao
• Format: Article
• Language: English
• Subjects: diffuse glioma; IDH1 mutation; Neurology; new-onset postoperative seizures; overall survival; risk factors
• ISSN: 1664-2295; 1664-2295
• DOI: 10.3389/fneur.2021.682535

Background: Glioma-related epilepsy (GRE) is the most common presenting sign of patients with diffuse glioma. According to clinical experience, new-onset postoperative seizures can be observed even in patients without preoperative GRE. The current study mainly aimed to explore the risk factors of new-onset postoperative seizures in those patients. In addition, the prognostic value of new-onset postoperative seizures was also discussed. Methods: Data of 313 patients without GRE were retrospectively reviewed. Chi-square test or Fisher's exact test were first performed to compare categorical variables between patients with new-onset postoperative seizures and those without. Subsequently, binary logistic regression analysis was conduct to further assess risk factors of new-onset postoperative seizures. Kaplan-Meier and Cox analysis were used to investigate the prognostic value of new-onset postoperative seizures for progression-free survival (PFS) and overall survival (OS). Results: Patients with low-grade tumors ( p = 0.006), isocitrate dehydrogenase 1 (IDH1) mutation ( p = 0.040) or low Ki-67 expression ( p = 0.005) showed a higher incidence of new-onset postoperative seizures. IDH1 mutation was identified as the only independent predictor for new-onset postoperative seizures (OR, 2.075; 95% CI, 1.051–4.098; p = 0.035). Additionally, new-onset postoperative seizure occurrence was demonstrated as an independent predicter of prolonged OS (OR, 0.574; 95% CI, 0.335–0.983; p = 0.043), while younger age, gross total resection, low-grade and IDH1 mutation were independently correlated with prolonged OS and PFS. Conclusions: IDH1 mutation is an independent predictor for new-onset postoperative seizures in patients without preoperative GRE. Moreover, new-onset postoperative seizures can independently predict prolonged OS in those patients. The results of the current study can contribute to improving the individualized management of diffuse glioma.