AUTHOR=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 

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

JOURNAL=Frontiers in Neurology

VOLUME=12

YEAR=2021

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2021.682535

DOI=10.3389/fneur.2021.682535

ISSN=1664-2295

ABSTRACT=<p><bold>Background:</bold> 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.</p><p><bold>Methods:</bold> 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).</p><p><bold>Results:</bold> Patients with low-grade tumors (<italic>p</italic> = 0.006), isocitrate dehydrogenase 1 (IDH1) mutation (<italic>p</italic> = 0.040) or low Ki-67 expression (<italic>p</italic> = 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; <italic>p</italic> = 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; <italic>p</italic> = 0.043), while younger age, gross total resection, low-grade and IDH1 mutation were independently correlated with prolonged OS and PFS.</p><p><bold>Conclusions:</bold> 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.</p>