Long-Term Seizure Outcomes and Predictors in Patients with Dysembryoplastic Neuroepithelial Tumors Associated with Epilepsy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Selection
2.2. Presurgical Assessments
2.3. Surgical Procedure
2.4. Follow-Up
2.5. Statistical Analysis
3. Results
3.1. Demographic Characteristics
3.2. Clinical Characteristics
3.3. Surgical Complications
3.4. Follow-Up and Outcomes
3.5. Univariable Survival Analysis
3.6. Multivariable Cox Regression Analysis
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
Appendix A
Time, Years | Cumulative Rate of Seizure Recurrence-Free (%) | Standard Error | 95% CI (%) |
---|---|---|---|
1 | 84.1 | 0.0460 | 75.6–93.7 |
2 | 82.5 | 0.0478 | 73.7–92.5 |
3 | 79.0 | 0.0518 | 69.5–89.9 |
4 | 79.0 | 0.0518 | 69.5–89.9 |
5 | 79.0 | 0.0518 | 69.5–89.9 |
6 | 76.5 | 0.0561 | 66.2–88.3 |
7 | 76.5 | 0.0561 | 66.2–88.3 |
8 | 76.5 | 0.0561 | 66.2–88.3 |
9 | 76.5 | 0.0561 | 66.2–88.3 |
10 | 76.5 | 0.0561 | 66.2–88.3 |
11 | 76.5 | 0.0561 | 66.2–88.3 |
12 | 76.5 | 0.0561 | 66.2–88.3 |
13 | 76.5 | 0.0561 | 66.2–88.3 |
Variable | Chi-Square | p-Value |
---|---|---|
Sex | 1.984 | 0.159 |
Age at onset | 7.400 | 0.007 * |
Duration | 10.076 | 0.002 * |
Age at surgery | 0.443 | 0.506 |
Auras | 0.002 | 0.964 |
Seizure frequency | 1.597 | 0.660 |
Seizure type | 0.343 | 0.842 |
Seizure kind | 0.640 | 0.726 |
Site of lesion | 0.846 | 0.358 |
MRI subtype 1 | 8.920 | 0.003 * |
IEDs 2 | 14.009 | 0.003 * |
Ictal onset rhythms | 4.964 | 0.174 |
Surgical type | 18.607 | <0.001 * |
Histopathological types | 7.480 | 0.058 |
Complications | 0.315 | 0.854 |
Variable | HR | p-Value | 95% CI |
---|---|---|---|
Sex | 2.19 | 0.160 | 0.73–6.54 |
Age at onset | 0.25 | 0.012 * | 0.08–0.74 |
Duration | 4.87 | 0.005 * | 1.63–14.56 |
Age at surgery | 1.42 | 0.510 | 0.50–4.06 |
Auras | 1.07 | 0.915 | 0.33–3.4 |
Seizure frequency | 1.33 | 0.325 | 0.75–2.35 |
Seizure type | 0.97 | 0.936 | 0.52–1.83 |
Seizure kind | 0.86 | 0.753 | 0.34–2.17 |
Lateral | 0.82 | 0.713 | 0.28–2.37 |
Site of lesion | 1.62 | 0.373 | 0.56–4.67 |
MRI subtype | 1.82 | 0.027 * | 1.07–3.10 |
IEDs | 1.64 | 0.017 * | 1.09–2.48 |
Ictal onset rhythms | 1.23 | 0.382 | 0.78–1.94 |
Surgical type | 7.90 | <0.001 * | 2.71–23.06 |
Histopathological types | 1.37 | 0.482 | 0.57–3.32 |
Complications | 1.51 | 0.528 | 0.42–5.42 |
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Characteristics | SF (n = 49) | NSF (n = 14) | p-Value |
---|---|---|---|
Sex | |||
Male | 28 (57.1%) | 5 (35.7%) | 0.266 |
Female | 21 (42.9%) | 9 (64.3%) | |
Age at seizure onset | |||
≤4 years | 4 (8.2%) | 5 (35.7%) | 0.030 * |
>4 years | 45 (91.8%) | 9 (64.3%) | |
Duration of seizures | |||
≤4 years | 39 (79.6%) | 5 (35.7%) | 0.005 * |
>4 years | 10 (20.4%) | 9 (64.3%) | |
Age at surgery | |||
≤16 years | 27 (55.1%) | 6 (42.9%) | 0.613 |
>16 years | 22 (44.9%) | 8 (57.1%) | |
Aura | |||
Yes | 35 (71.4%) | 10 (71.4%) | 1.000 |
No | 14 (28.6%) | 4 (28.6%) | |
Seizure frequency | |||
Daily | 10 (20.4%) | 1 (7.1%) | 0.654 |
Weekly | 15 (30.6%) | 4 (28.6%) | |
Monthly | 17 (34.7%) | 7 (50.0%) | |
Yearly | 7 (14.3%) | 2 (14.3%) | |
Seizure types | |||
Focal only | 27 (55.1%) | 7 (50.0%) | 0.848 |
Generalized only | 10 (20.4%) | 4 (28.6%) | |
Both | 12 (24.5%) | 3 (21.4%) | |
IEDs | |||
Regional | 31 (63.3%) | 2 (14.3%) | 0.002 * |
Unilateral | 3 (6.1%) | 2 (14.3%) | |
Bilateral | 5 (10.2%) | 6 (42.9%) | |
Nonspecific | 10 (20.4%) | 4 (28.6%) | |
Ictal onset rhythms | |||
Regional | 16 (32.7%) | 2 (14.3%) | 0.523 |
Unilateral | 6 (12.2%) | 2 (14.3%) | |
Bilateral | 13 (26.5%) | 6 (42.9%) | |
Not captured | 14 (28.6%) | 4 (28.6%) | |
Laterality of tumor in preoperative MRI | |||
Left | 26 (53.1%) | 8 (57.1%) | 1.000 |
Right | 23 (46.9%) | 6 (42.9%) | |
Site of lesion | |||
Temporal | 21 (42.9%) | 8 (57.1%) | 0.521 |
Extratemporal | 28 (57.1%) | 6 (42.9%) | |
MRI subtype | |||
Type 1 | 42 (85.7%) | 8 (57.1%) | 0.020 * |
Type 2 | 2 (4.1%) | 0 (0%) | |
Type 3 | 5 (10.2%) | 6 (42.9%) | |
Surgical type 1 | |||
GTR | 44 (89.8%) | 6 (42.9%) | <0.001 * |
NTR | 5 (10.2%) | 6 (42.9%) | |
STR | 0 (0%) | 2 (14.3%) | |
Histopathological types 2 | |||
Simple form | 36 (73.5%) | 10 (71.4%) | 0.146 |
Complex form | 12 (24.5%) | 2 (14.3%) | |
Nonspecific form | 1 (2.0%) | 2 (14.3%) | |
Complication | |||
No | 42 (85.7%) | 12 (85.7%) | 0.822 |
Temporary | 5 (10.2%) | 1 (7.1%) | |
Permanent | 2 (4.1%) | 1 (7.1%) |
Variables | Univariable Analysis | Multivariable Analysis | ||||
---|---|---|---|---|---|---|
HR | p-Value | 95%CI | HR | p-Value | 95%CI | |
Age at seizure onset | ||||||
≤4 years | 1.00 | |||||
>4 years | 0.25 | 0.012 * | 0.08–0.74 | 0.94 | 0.939 | 0.20–4.43 |
Duration of seizures | ||||||
≤4 years | 1.00 | |||||
>4 years | 4.87 | 0.005 * | 1.63–14.56 | 4.32 | 0.016 * | 1.31–14.2 |
IEDs | ||||||
Regional | 1.00 | |||||
Unilateral | 10.09 | 0.021 * | 1.41–72.09 | 4.91 | 0.130 | 0.63–38.47 |
Bilateral | 12.09 | 0.002 * | 2.43–60.09 | 6.38 | 0.047 * | 1.03–39.64 |
Nonspecific | 5.33 | 0.054 | 0.97–29.13 | 1.26 | 0.817 | 0.18–8.91 |
MRI subtype | ||||||
Type 1 | 1.00 | |||||
Type 2 | 0.00 | 0.999 | 0.00–Inf | 0.00 | 0.999 | 0.00–Inf |
Type 3 | 4.26 | 0.007 * | 1.47–12.32 | 1.31 | 0.705 | 0.33–5.25 |
Surgical type | ||||||
GTR | 1.00 | |||||
Non-GTR | 7.86 | <0.001 * | 2.70–22.95 | 6.38 | 0.031 * | 1.18–34.37 |
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Zhang, H.; Hu, Y.; Aihemaitiniyazi, A.; Li, T.; Zhou, J.; Guan, Y.; Qi, X.; Zhang, X.; Wang, M.; Liu, C.; et al. Long-Term Seizure Outcomes and Predictors in Patients with Dysembryoplastic Neuroepithelial Tumors Associated with Epilepsy. Brain Sci. 2023, 13, 24. https://doi.org/10.3390/brainsci13010024
Zhang H, Hu Y, Aihemaitiniyazi A, Li T, Zhou J, Guan Y, Qi X, Zhang X, Wang M, Liu C, et al. Long-Term Seizure Outcomes and Predictors in Patients with Dysembryoplastic Neuroepithelial Tumors Associated with Epilepsy. Brain Sciences. 2023; 13(1):24. https://doi.org/10.3390/brainsci13010024
Chicago/Turabian StyleZhang, Huawei, Yue Hu, Adilijiang Aihemaitiniyazi, Tiemin Li, Jian Zhou, Yuguang Guan, Xueling Qi, Xufei Zhang, Mengyang Wang, Changqing Liu, and et al. 2023. "Long-Term Seizure Outcomes and Predictors in Patients with Dysembryoplastic Neuroepithelial Tumors Associated with Epilepsy" Brain Sciences 13, no. 1: 24. https://doi.org/10.3390/brainsci13010024
APA StyleZhang, H., Hu, Y., Aihemaitiniyazi, A., Li, T., Zhou, J., Guan, Y., Qi, X., Zhang, X., Wang, M., Liu, C., & Luan, G. (2023). Long-Term Seizure Outcomes and Predictors in Patients with Dysembryoplastic Neuroepithelial Tumors Associated with Epilepsy. Brain Sciences, 13(1), 24. https://doi.org/10.3390/brainsci13010024