Dissemin is shutting down on January 1st, 2025

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Springer, Journal of Neuro-Oncology, 2(160), p. 403-411, 2022

DOI: 10.1007/s11060-022-04158-6

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Seizures in patients with IDH-mutated lower grade gliomas

Journal article published in 2022 by Louise Carstam ORCID, Isabelle Rydén ORCID, Asgeir Store Jakola
This paper is made freely available by the publisher.
This paper is made freely available by the publisher.

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Abstract

Abstract Purpose Most patients with Lower Grade Gliomas (LGG) present with epileptic seizures. Since the advent of molecular diagnostics, more homogenous sub-entities have emerged, including the isocitrate dehydrogenase-mutated (IDH-mutated) astrocytomas and 1p19q-codeleted oligodendrogliomas. We aimed to describe the occurrence of seizures in patients with molecularly defined LGG pre- and postoperatively and to analyze factors affecting seizure status postoperatively. Methods A population-based cohort of 130 adult patients with IDH-mutated WHO grade 2 or 3 astrocytomas and oligodendrogliomas was assessed pertaining to seizure burden before and after surgery. Results Fifty-four (79.4%) patients with astrocytoma and 45 (72.6%) patients with oligodendroglioma had a history of seizures before surgery. At 12 months postoperatively, 51/67 (76.1%) patients with astrocytoma and 47/62 (75.8%) patients with oligodendrogliomas were seizure free. In a multivariable logistic regression analysis, lower extent of resection (EOR) (OR 0.98; 95% CI 0.97–1.00, p = 0.01) and insular tumor location (OR 5.02; 95% CI 1.01–24.87, p = 0.048) were associated with presence of seizures within 1 year postoperatively in the entire LGG cohort. In sub-entities, EOR was in a similar manner associated with seizures postoperatively in astrocytomas (OR 0.98; 95% CI 0.96–0.99, p < 0.01) but not in oligodendrogliomas (p = 0.34). Conclusion Our results are well in line with data published for non-molecularly defined LGG with a large proportion of patients being seizure free at 1 year postoperative. Better seizure outcome was observed with increased EOR in astrocytomas, but this association was absent in oligodendrogliomas.